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World J Gastroenterol. May 21, 2014; 20(19): 5672-5678
Published online May 21, 2014. doi: 10.3748/wjg.v20.i19.5672
Treatment of early gastric cancer in the Western World
Elfriede Bollschweiler, Felix Berlth, Christoph Baltin, Stefan Mönig, Arnulf H Hölscher
Elfriede Bollschweiler, Felix Berlth, Christoph Baltin, Stefan Mönig, Arnulf H Hölscher, Department of General, Visceral and Cancer Surgery, University of Cologne, 50937 Cologne, Germany
Author contributions: Bollschweiler E, Mönig S and Hölscher AH are responsible for the scientific context of the manuscript; Berlth F and Baltin C performed the systematic search of literature; Bollschweiler E designed the review and wrote the manuscript.
Correspondence to: Elfriede Bollschweiler, Professor, Department of General, Visceral and Cancer Surgery, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany. elfriede.bollschweiler@uk-koeln.de
Telephone: +49-221-4786273 Fax: +49-221-4785076
Received: October 29, 2013
Revised: January 3, 2014
Accepted: February 16, 2014
Published online: May 21, 2014
Processing time: 201 Days and 10.9 Hours
Abstract

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.

Keywords: Gastric cancer; Early cancer; Epidemiology; Diagnosis; Therapy; Western World

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.