Treatment of Well or Moderately Differentiated Early Gastric Cancer — Mucosal Tumor ≤2 cm Without Ulceration

This protocol covers a precisely defined subset of early gastric cancer characterised by favourable endoscopic and histological features, where a specific minimally invasive approach is recommended as the first-line intervention.

Clinical Scenario

The following endoscopic and pathological criteria together define this population:

Well or moderately differentiated tubular or papillary histology
Endoscopically estimated tumor size ≤2 cm
Endoscopically confirmed mucosal cancer (no submucosal extension)
No ulceration within the tumor

Treatment Approach

For patients whose tumor meets all four criteria above, the guideline-recommended first-line intervention is an endoscopic resection procedure. This approach is minimally invasive and has been established practice for appropriately selected early gastric cancer cases.

The complete structured regimen — including procedural specifics, assessment thresholds, and follow-up pathway — is available via the protocol link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.5230/jgc.2025.25.e11

Endoscopic resection is recommended for well or moderately differentiated tubular or papillary EGCs meeting the following endoscopic findings: endoscopically estimated tumor size ≤2 cm, endoscopically mucosal cancer, and no ulcer in the tumor.

Since the early 2000s, ESD has been used in Korea as a minimally invasive therapy modality for EGC.

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