Open AccessEarly gastric cancer: A challenge in Western countries
Author(s) -
Maria Michela Chiarello,
Valeria Fico,
Gilda Pepe,
Giuseppe Tropeano,
Neill James Adams,
Gaia Altieri,
Giuseppe Brisinda
Publication year - 2022
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v28.i7.693
Subject(s) - medicine , submucosa , lymphadenectomy , endoscopic mucosal resection , lymph node , gastrectomy , stomach , cholecystectomy , cancer , duodenum , general surgery , lesion , surgery , endoscopy , gastroenterology
Early gastric cancer (EGC) is an invasive carcinoma involving only the stomach mucosa or submucosa, independently of lymph node status. EGC represents over 50% of cases in Japan and in South Korea, whereas it accounts only for approximately 20% of all newly diagnosed gastric cancers in Western countries. The main classification systems of EGC are the Vienna histopathologic classification and the Paris endoscopic classification of polypoid and non-polypoid lesions. A careful endoscopic assessment is fundamental to establish the best treatment of EGC. Generally, EGCs are curable if the lesion is completely removed by endoscopic resection or surgery. Some types of EGC can be resected endoscopically; for others the most appropriate treatment is surgical resection and D2 lymphadenectomy, especially in Western countries. The favorable oncological prognosis, the extended lymphadenectomy and the reconstruction of the intestinal continuity that excludes the duodenum make the prophylactic cholecystectomy mandatory to avoid the onset of biliary complications.