Post written by Waku Hatta, MD, PhD, from the Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.

Our study focused on evaluating the risk factors of early and late cancer recurrences in patients who were followed up without additional radical surgery after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) categorized as “non-curative resection,” which is referred to as “curability C-2” in the latest Japanese guidelines.

Different risk factors between early and late cancer recurrences may help clinicians decide the treatment strategy for patients who have a relatively shorter life expectancy after ESD for EGC categorized as curability C-2.

Our study first demonstrated the different roles played by lymphatic and vascular invasions in cancer recurrence; lymphatic invasion mainly for early recurrence and vascular invasion for late recurrence. This finding may contribute to decision making regarding treatment strategies after ESD for EGC categorized as curability C-2, especially in patients with a relatively shorter life expectancy.

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