[Endoluminal therapy of neoplastic changes of the gastrointestinal tract: questionable and reliable aspects. Early stomach carcinoma: surgical treatment].

: Early gastric cancer (EGC) is defined as gastric carcinoma limited to the mucosa and submucosa of the gastric wall, corresponding to UICC stage pT1a or pT1b. The overall prognosis is excellent, with 5-year survival rates up to 95% reported by Japanese institutions as well as in some series from Europe and the USA. However, the therapeutic concept still is indifferent. New staging methods and advances in the endoscopic and laparoscopic treatment opened new fields of therapeutic approaches. Therefore, referring to the results of japanese studies, for defined subtypes of EGC an endoscopic approach can be recommended. This, however, is related to a close follow up of these patients. In case of a surgical resection, radical D2-lymphadenectomy should be performed, especially in patients with submucosal invasion.