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World J Gastrointest Endosc. Mar 16, 2023; 15(3): 114-121
Published online Mar 16, 2023. doi: 10.4253/wjge.v15.i3.114
Endoscopic advances in the management of gastric cancer and premalignant gastric conditions
Erica Park, Makoto Nishimura, Priya Simoes
Erica Park, Priya Simoes, Division of Gastroenterology and Hepatology, Mount Sinai Morningside and West, New York, NY 10025, United States
Makoto Nishimura, Gastroenterology, Hepatology and Nutrition Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
Author contributions: Park E and Simoes P wrote the manuscript; Nishimura M provided figures for the manuscript; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Erica Park, MD, Academic Fellow, Division of Gastroenterology and Hepatology, Mount Sinai Morningside and West, 1111 Amsterdam Ave, Stuy 12, New York, NY 10025, United States. ericakimberlypark@gmail.com
Received: September 23, 2022
Peer-review started: September 23, 2022
First decision: November 4, 2022
Revised: December 17, 2022
Accepted: February 10, 2023
Article in press: February 10, 2023
Published online: March 16, 2023
Processing time: 174 Days and 5.9 Hours
Abstract

Gastric cancer is the fifth most common cancer and in 2018, it was the third most common cause of cancer-related deaths worldwide. Endoscopic advances continue to be made for the diagnosis and management of both early gastric cancer and premalignant gastric conditions. In this review, we discuss the epidemiology and risk factors of gastric cancer and emphasize the differences in early vs late-stage gastric cancer outcomes. We then discuss endoscopic advances in the diagnosis of early gastric cancer and premalignant gastric lesions. This includes the implementation of different imaging modalities such as narrow-band imaging, chromoendoscopy, confocal laser endomicroscopy, and other experimental techniques. We also discuss the use of endoscopic ultrasound in the diagnosis and staging of early gastric cancer. We then discuss the endoscopic advances made in the treatment of these conditions, including endoscopic mucosal resection, endoscopic submucosal dissection, and hybrid techniques such as laparoscopic endoscopic cooperative surgery. Finally, we comment on the current suggested recommendations for surveillance of both gastric cancer and its premalignant conditions.

Keywords: Gastric cancer; Premalignant gastric conditions; Endoscopy; Narrow-band imaging; Endoscopic mucosal resection; Endoscopic submucosal dissection; Gastric cancer surveillance

Core Tip: Consider screening for gastric cancer in appropriate patient populations, as early gastric cancer outcomes are associated with improved survival. Use of different imaging modalities during endoscopy such as narrow-band imaging may improve detection of gastric cancer and premalignant gastric conditions. Endoscopic mucosal resection and submucosal dissection have shown favorable long-term outcomes. While there are no established evidence-based gastric cancer surveillance guidelines in the United States, other studies have suggested annual surveillance after gastric cancer resection. Endoscopic surveillance of premalignant gastric conditions may be considered, with closer intervals in patients with evidence of dysplasia.