[Endoscopic therapy in early gastric cancer]

Endoscopic treatment of early gastric cancer has been shown to be effective and safe. It is a minimally invasive and organ-preserving treatment approach that can safely be used as an alternative to surgical resection. A prerequisite of any endoscopic treatment with a curative intent is a very low risk of lymph node metastasis of the lesion intended to be endoscopically resected. As in high-volume surgical centers all endoscopic procedures with a curative intent should also be carried out in centers with a high expertise in the different endoscopic resection (ER) techniques available, the major techniques being suck-and-cut ER and endoscopic submucosal dissection (ESD). Because of the risk of secondary neoplasia after curative endoscopic therapy, a standardized follow-up protocol is required. The majority of secondary neoplastic lesions can again be treated endoscopically. In the present article an overview of initial staging procedures, techniques, indications, as well as follow-up strategies after endoscopic therapy for early gastric cancer is given.