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KMID : 0614620200750050264
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Korean Journal of Gastroenterology
2020 Volume.75 No. 5 p.264 ~ p.291
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Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer
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Park Chan-Hyuk
Yang Dong-Hoon
Kim Jong-Wook
Kim Jie-Hyun
Kim Ji-Hyun
Min Yang-Won
Lee Si-Hyung
Bae Jung-Ho
Chung Hyun-Soo
Choi Kee-Don
Park Jun-Chul
Lee Hyuk
Kwak Min-Seob
Kim Bun
Lee Hyun-Jung
Lee Hye-Seung
Choi Mi-Young
Park Dong-Ah
Lee Jong-Yeul
Byeon Jeong-Sik
Park Chan-Guk
Cho Joo-Young
Lee Soo-Teik
Chun Hoon-Jai
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Abstract
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Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
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KEYWORD
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Early colorectal cancer, Early gastric cancer, Endoscopic resection, Guideline, Superficial esophageal squamous cell carcinoma
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