Cheema HI, Tharian B, Inamdar S, Garcia-Saenz-de-Sicilia M, Cengiz C. Recent advances in endoscopic management of gastric neoplasms. World J Gastrointest Endosc 2023; 15(5): 319-337 [PMID: 37274561 DOI: 10.4253/wjge.v15.i5.319]
Corresponding Author of This Article
Cem Cengiz, MD, Chief Physician, Division of Gastroenterology and Hepatology, Department of Internal Medicine, John L. McClellan Memorial Veterans Hospital, 4300 W 7th Street, Little Rock, AR 72205, United States. cemcengizmd@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. May 16, 2023; 15(5): 319-337 Published online May 16, 2023. doi: 10.4253/wjge.v15.i5.319
Recent advances in endoscopic management of gastric neoplasms
Hira Imad Cheema, Benjamin Tharian, Sumant Inamdar, Mauricio Garcia-Saenz-de-Sicilia, Cem Cengiz
Hira Imad Cheema, Department of Internal Medicine, Baptist Health Medical Center, Little Rock, AR 72205, United States
Benjamin Tharian, Department of Interventional Endoscopy/Gastroenterology, Bayfront Health, Digestive Health Institute, St. Petersberg, FL 33701, United States
Sumant Inamdar, Mauricio Garcia-Saenz-de-Sicilia, Cem Cengiz, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
Cem Cengiz, Division of Gastroenterology and Hepatology, Department of Internal Medicine, John L. McClellan Memorial Veterans Hospital, Little Rock, AR 72205, United States
Cem Cengiz, Division of Gastroenterology and Hepatology, Department of Internal Medicine, TOBB University of Economics and Technology, Ankara 06510, Turkey
Author contributions: All authors contributed equally to the following: (1) Substantial contributions to conception and design of the study, and acquisition, analysis, and interpretation of the data; (2) Drafting the article and making critical revisions related to important intellectual content of the manuscript; and (3) Final approval of the version of the article to be published.
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: Cem Cengiz, MD, Chief Physician, Division of Gastroenterology and Hepatology, Department of Internal Medicine, John L. McClellan Memorial Veterans Hospital, 4300 W 7th Street, Little Rock, AR 72205, United States. cemcengizmd@yahoo.com
Received: September 20, 2022 Peer-review started: September 20, 2022 First decision: November 11, 2022 Revised: January 12, 2023 Accepted: April 6, 2023 Article in press: April 6, 2023 Published online: May 16, 2023 Processing time: 238 Days and 5.4 Hours
Abstract
The development and clinical application of new diagnostic endoscopic technologies such as endoscopic ultrasonography with biopsy, magnification endoscopy, and narrow-band imaging, more recently supplemented by artificial intelligence, have enabled wider recognition and detection of various gastric neoplasms including early gastric cancer (EGC) and subepithelial tumors, such as gastrointestinal stromal tumors and neuroendocrine tumors. Over the last decade, the evolution of novel advanced therapeutic endoscopic techniques, such as endoscopic mucosal resection, endoscopic submucosal dissection, endoscopic full-thickness resection, and submucosal tunneling endoscopic resection, along with the advent of a broad array of endoscopic accessories, has provided a promising and yet less invasive strategy for treating gastric neoplasms with the advantage of a reduced need for gastric surgery. Thus, the management algorithms of various gastric tumors in a defined subset of the patient population at low risk of lymph node metastasis and amenable to endoscopic resection, may require revision considering upcoming data given the high success rate of en bloc resection by experienced endoscopists. Moreover, endoscopic surveillance protocols for precancerous gastric lesions will continue to be refined by systematic reviews and meta-analyses of further research. However, the lack of familiarity with subtle endoscopic changes associated with EGC, as well as longer procedural time, evolving resection techniques and tools, a steep learning curve of such high-risk procedures, and lack of coding are issues that do not appeal to many gastroenterologists in the field. This review summarizes recent advances in the endoscopic management of gastric neoplasms, with special emphasis on diagnostic and therapeutic methods and their future prospects.
Core Tip: Minimally invasive and advanced endoscopic procedures have reduced the need for extensive and invasive surgical procedures for early gastric cancer and subepithelial tumors. These novel techniques have decreased side effects, duration of hospitalization, and sedation requirements. The possibilities evolve constantly from improved diagnosis to better therapeutic techniques. This review discusses current endoscopic techniques for the diagnosis and treatment of gastric neoplasms, with special focus on guidelines and newly developed tools and methods.
