Treatment of Stomach Cancer with Stomach Mucosal Mass: Well or Moderately Differentiated Tubular or Papillary Early Gastric Cancer

This protocol addresses a specific subgroup of early gastric cancer (EGC): tumors of well or moderately differentiated tubular or papillary histology, confirmed as endoscopically mucosal cancer, meeting defined size and ulcer criteria on endoscopic assessment.

Stomach Mucosal Mass — Applicable Clinical Scenario

The patient presents with an endoscopically confirmed mucosal gastric mass of well or moderately differentiated tubular or papillary type. The defining endoscopic criteria are a tumor estimated at greater than 2 cm with no ulceration in the tumor, or a tumor estimated at 3 cm or less with ulceration present in the tumor.

Treatment Approach — Partial Overview

For tumors meeting these endoscopic criteria, both an endoscopic approach and a surgical approach involving lymph node management may be appropriate. Which option applies, and under what specific conditions one may be preferred over the other, is detailed in the full structured regimen.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.5230/jgc.2025.25.e11

ESD as well as gastrectomy with LN dissection can be indicated 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, or endoscopically estimated tumor size ≤3 cm, endoscopically mucosal cancer, and ulcer in the tumor.
Consequently, gastrectomy with LN dissection may also be a valid treatment option, especially in cases of ESD with technical difficulty or when periodic endoscopic follow-up is not be feasible or affordable.

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