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.