Published online May 21, 2014. doi: 10.3748/wjg.v20.i19.5672
Revised: January 3, 2014
Accepted: February 16, 2014
Published online: May 21, 2014
Processing time: 201 Days and 10.9 Hours
The incidence rate of gastric cancer is much higher in Asia than in the Western industrial nations. According to the different screening programs in Japan and Korea about fifty percent of treated patients had an early tumor stage. In contrast, European and American patients with gastric cancer had an advanced tumor stage. Therefore, the experience for the various therapeutic options for gastric cancer may be different between these regions. In this review we tried to point out the treatment modalities in Western industrial countries for early gastric cancer.
Core tip: Early gastric cancer is a challenging disease with varying lymph node infiltration. In the Western industrial countries the frequency of early gastric cancer is much lower than in Asian countries. Especially, carcinomas limited to the mucosa are rare in the West. Therefore the experience of endoscopic therapy or minimal invasive surgery is only in special centers available. Total or subtotal gastrectomy with D2-lymphadenectomy is the standard treatment for early gastric cancer with suspected lymph node metastases. Future studies including prediction of lymph node metastasis are necessary to optimize the therapy according to quality of life.