Gastric cancer is the most common cancer worldwide and it is often diagnosed in an advanced stage. In countries wherescreening endoscopy is performed widely, early detection is possible. In fact, early gastric cancer incidence is increasing during the last years worldwide and screening could be a major factor in such increase. In the past, the standard treatment of gastric cancer was surgical resection; however, the endoscopic treatment has increased due to advances in the instruments available and clinician experience. In fact, endoscopic resection has become one of the greatest advances in EGC treatment. It is the standard treatment in most of the cases because early gastric cancer is associated with a low rate of lymph node metastasis and a high survival rate. Endoscopic Mucosal Resection and more recently Endoscopic Submucosal Dissection are the two main developed procedures. Endoscopic Submucosal Dissection achieves a higher rate of en-bloc resection, complete resection, curative resection and lower local recurrence compared with Endoscopic Mucosal Resection group. The disadvantages associated with Endoscopic Submucosal Dissection, such as higher perforation rates and longer procedure time, will probably improve as the endoscopists experience increases and new endoscopic tools are developed.The aim of this paper is to review the management of EGC with a special focus on endoscopic detection, staging, therapy, surveillance, and prevention.
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A. Ferrández, S. Mostacero and A. Lanas, "Endoscopic Staging and Treatment of Early Gastric Cancer," Journal of Cancer Therapy, Vol. 4 No. 1, 2013, pp. 92-98. doi: 10.4236/jct.2013.41A013.
 V. Baptista, A. Singh and W. Wassef, “Early Gastric Cancer: An Update on Endoscopic Management,” Current Opinion in Gastroenterology, Vol. 28, No. 6, 2012, pp. 629-635.
 M. Tada, M. Shimada, F. Murakami, M. Mizumachi, K. Arima, H. Yanai, et al., “Development of Strip-Off Biopsy (in Japanese with English Abstract),” Gastrointestinal Endoscopy, Vol. 26, 1984, pp. 833-839.
 M. Hirao, K. Masuda, T. Asanuma, H. Nala, K. Noda, K. Matsuura, O. Yamaguchi and N. Ueda, “Endoscopicresection of Earlygastriccancerwith Local Injection of Hypertonicsaline-Epinephrine,” Gastrointestinal Endoscopy, Vol. 34, No. 3, 1998, pp. 264-269.
 K. Hosokawa and S. Yoshida, “Recentadvances in Endoscopic Mucosal Resection for Early Gastric Cancer (with English Abstract),” Japanese Journal of Cancer and Chemotherapy, Vol. 25, 1998, p. 483.
 N. Yamaguchi, H. Isomoto, E. Fukuda, K. Ikeda, H. Nishiyama, M. Akiyama, E. Ozawa, K. Ohnita, T. Hayashi, K. Nakao, S. Kohno and S. Shikuwa, “Clinical Outcomes of Endoscopic Submucosaldissection for Early Gastric Cancer by Indication Criteria,” Digestion, Vol. 80, No. 3, 2009, pp. 173-181. doi:10.1159/000215388
 Japanese Gastric Cancer Association, “Japanese Classification of Gastric Carcinoma,” Gastric Cancer, Vol. 1, 1998, pp. 10-24.
 Y. Ezoe, M. Muto, N. Uedo, H. Doyama, K. Yao, I. Oda, K. Kaneko, Y. Kawahara, C. Yokoi, Y. Sugiura, H. Ishikawa, Y. Takeuchi, Y. Kaneko and Y. Saito, “Magnifying Narrow Band Imaging Is more Accurate than Conventional White-Light Imaging in Diagnosis of Gastric Mucosal Cancer,” Gastroenterology, Vol. 141, No. 6, 2011, pp. 2017-2025. doi:10.1053/j.gastro.2011.08.007
 J. Zhang, S. B. Guo and Z. J. Duan, “Application of Magnifying Narrow-Band Imaging Endoscopy for Diagnosis of Early Gastric Cancer and Precancerous Lesion,” BMC Gastroenterology, Vol. 11, 2011, pp. 135-141.
 P. Pimentel-Nunes, M. Dinis-Ribeiro, J. B. Soares, et al., “A Multicenter Validation of an Endoscopic Classification with Narrow Band Imaging for Gastric Precancerous and Cancerous Lesions,” Endoscopy, Vol. 44, No. 3, 2012, pp. 236-246. doi:10.1055/s-0031-1291537
 R. M. Kwee and T. C. Kwee, “Imaging in Local Staging of Gastric Cancer: A Systematic Review,” Journal of Clinical Oncology, Vol. 20;25, No. 15, 2007, pp. 2107-2116. doi:10.1200/JCO.2006.09.5224
 R. Seevaratnam, R. Cardoso, C. McGregor, L. Lourenco, A. Mahar, R. Sutradhar, C. Law, L. Paszat and N. Coburn, “How Useful Is Preoperative Imaging for Tumor, Node, Metastasis (TNM) Staging of Gastric Cancer? A Meta-Analysis,” Gastric Cancer, Vol. 15, No. Suppl 1, 2012, pp. 3-18. doi:10.1007/s10120-011-0069-6
 J. J. Bergman and P. Fockens, “Endoscopic Ultrasonography in Patients with Gastro-Esophageal Cancer,” European Journal of Ultrasound, Vol. 10, No. 2-3, 1999, pp. 127-138. doi:10.1016/S0929-8266(99)00055-5
 S. Yamamoto, T. Nishida, M. Kato, T. Inoue, Y. Hayashi, J. Kondo, T. Akasaka, T. Yamada, S. Shinzaki, H. Iijima, M. Tsujii and T. Takehara, “Evaluation of Endoscopic Ultrasound Image Quality Is Necessary in Endosonographic Assessment of Early Gastric Cancer Invasion Depth,” Gastroenterology Research and Practice, Vol. 2012, 2012, Article ID: 194530.
 S. Mocellin, A. Marchet and D. Nitti, “EUS for the Staging of Gastric Cancer: A Meta-Analysis,” Gastrointestinal Endoscopy, Vol. 73, No. 6, 2011, pp. 1122-1134.
 H. Yanai, T. Noguchi, S. Mizumachi, H. Tokiyama, H. Nakamura, M. Tada and K. Okita, “A Blind Comparison of the Effectiveness of Endoscopic Ultrasonography and Endoscopy in Staging Early Gastric Cancer,” Gut, Vol. 44, No. 3, 1999, pp. 361-365. doi:10.1136/gut.44.3.361
 R. M. Kwee and T. C. Kwee, “Imaging in Local Staging of Gastriccancer: A Systematicreview,” Journal of Clinical Oncology, Vol. 25, No. 15, 2007, pp. 2107-2116.
 S. Bhandari, C. S. Shim, J. H. Kim, I. S. Jung, J. Y. Cho, J. S. Lee, M. S. Lee and B. S. Kim, “Usefulness of Three-Dimensional, Multidetector Row CT (Virtual Gastroscopy and Multiplanar Reconstruction) in the Evaluation of Gastric Cancer: A Comparison with Convention Alendoscopy, EUS, and Histopathology,” Gastrointestinal Endoscopy, Vol. 59, No. 6, 2004, pp. 619-626. doi:10.1016/S0016-5107(04)00169-5
 M. Tanaka, H. Ono, N. Hasuike and K. Takizawa, “Endoscopic Submucosal Dissection of Early Gastric Cancer,” Digestion, Vol. 77, No. Suppl 1, 2008, pp. 23-28.
 Y. M. Park, E. Cho, H. Y. Kang and J. M. Kim, “The Effectiveness and Safety of Endoscopic Submucosal Dissection Compared with Endoscopic Mucosal Resection for Early Gastric Cancer: A Systematic Review and Meta-Analysis,” Surgical Endoscopy, Vol. 25, No. 8, 2011, pp. 2666-2677. doi:10.1007/s00464-011-1627-z
 T. Watanabe, K. Kume, M. Taip, M. Shibata, H. Kubo, Y. Ejiri and M. Otsuki, “Gastric Mucosal Cancer Smaller than 7 mm Can Be Treated with Conventional Endoscopic Mucosal Resection as Effectively as with Endoscopic Submucosal Dissection,” Hepatogastroenterology, Vol. 57, No. 99-100, 2010, pp. 668-673.
 K. J. Kang, K. M. Kim, B. H. Min, J. H. Lee and J. J. Kim, “Endoscopic Submucosal Dissection of Early Gastric Cancer,” Gut and Liver, Vol. 5, No. 4, 2011, pp. 418-426.
 T. Gotoda, “Endoscopic Resection of Early Gastric Cancer,” Gastric Cancer, Vol. 10, No. 1, 2007, pp. 1-11.
 T. Gotoda, H. Yamamoto and R. M. Soetikno, “Endoscopic Submucosal Dissection of Early Gastric Cancer,” Journal of Gastroenterology, Vol. 41, No. 10, 2006, pp. 929-942. doi:10.1007/s00535-006-1954-3
 J. Lian, S. Chen, Y. Zhang and F. Qiu, “A Meta-Analysis of Endoscopic Submucosal Dissection and EMR for Early Gastric Cancer,” Testinal Endoscopy, Vol. 76, No. 4, 2012, pp. 763-770. doi:10.1016/j.gie.2012.06.014
 N. Uedo, Y. Takeuchi, T. Yamada, R. Ishihara, H. Ogiyama, S. Yamamoto, M. Kato, K. Tatsumi, E. Masuda, C. Tamai, S. Yamamoto, K. Higashino, H. Iishi and M. Tatsuta, “Effect of a Proton Pump Inhibitor or an H2-Receptor Antagoniston Prevention of Bleeding from Ulcer after Endoscopic Submucosal Dissection of Early Gastric Cancer: A Prospective Randomized Controlled Trial,” The American Journal of Gastroenterology, Vol. 102, No. 8, 2007, pp. 1610-1616.
 S. Coda, I. Oda, T. Gotoda, C. Yokoi, T. Kikuchi and H. Ono, “Risk Factors for Cardiac and Pyloric Stenosis after Endoscopic Submucosal Dissection, and Efficacy of Endoscopic Balloon Dilation Treatment,” Endoscopy, Vol. 41, No. 5, 2009, pp. 421-426.