Early gastric cancer: A challenge in Western countries

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.

Automated summary

Early gastric cancer (EGC) is a tumor that only invades the mucosa or submucosa of the stomach, regardless of the lymph node status. EGC is more common in Japan and South Korea compared to Western countries. The Vienna histopathologic classification and the Paris endoscopic classification are the main classification systems for EGC. A careful endoscopic assessment is crucial for determining the best treatment approach, with the option of endoscopic resection or surgical resection and lymphadenectomy depending on the type of EGC.