Risk Assessment of Lymph Node Metastases in Early Gastric Adenocarcinoma Fulfilling Expanded Endoscopic Resection Criteria

Early gastric cancer (EGC) is known to present a low rate of lymph node metastases (LNMs). Gastrectomy with D2 lymphadenectomy is usually curative for EGC. Endoscopic submucosal dissection (ESD) is a well-accepted treatment modality for lesions that meet the classic criteria: those mucosal differentiated adenocarcinoma measuring 20 mm or less, without ulceration. Expanded criteria for ESD have been proposed based on null LNM rate from large gastrectomies series from Japan. Patients with LNM have been reported in Western centers, emerging the need for validation of expanded criteria.

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