Published online Jun 15, 2021. doi: 10.4251/wjgo.v13.i6.560
Peer-review started: February 5, 2021
First decision: March 29, 2021
Revised: March 31, 2021
Accepted: May 22, 2021
Article in press: May 22, 2021
Published online: June 15, 2021
The development of endoscopic treatment technology has further promoted the minimally invasive treatment of early gastric cancer (EGC). Endoscopic treatment has achieved better therapeutic effects in terms of safety and prognosis and is the preferred treatment method for patients who meet the indications for endoscopic treatment. However, the consequent problem is that some patients receiving endoscopic treatment may undergo non-curative resection, and the principle of follow-up management for non-curative resection patients deserves further attention. In addition, there are still debates on how to improve the accuracy of clinical staging, select a reasonable treatment method for patients who meet the expanded indications for endoscopic treatment, manage patients with positive endoscopic surgical margins, conduct research on function-preserving surgery, and manage the treatment of EGC under the current situation in China. Consequently, we aim to review current indications for endoscopic submucosal dissection of EGC in order to better inform treatment options.
Core Tip: Gastric cancer is a worldwide public health problem with a lower cure rate and worse prognosis. With the improvement of people’s health awareness and the popularization of physical examination, the detection rate of early gastric cancer is increasing each year. Helicobacter pylori and Epstein-Barr virus are important pathogenic factors for gastric cancer. For patients who meet with the absolute and expanded indications for endoscopic treatment, endoscopic submucosal dissection can have the same therapeutic effect as surgery while reducing surgical trauma. For non-curative resection, laparoscopic subtotal gastrectomy or function-preserving gastrectomy can be performed based on the patient’s condition.