Curative criteria for endoscopic treatment of gastric cancer.

Endoscopic treatment, particularly endoscopic submucosal dissection, has become the primary treatment for early gastric cancer. A comprehensive optical assessment, including white light endoscopy, image-enhanced endoscopy, and magnification, are the cornerstones for clinical staging and determining the resectability of lesions. This paper discusses factors that influence the indication for endoscopic resection and the likelihood of achieving a curative resection. Our review stresses the critical need for interpreting the histopathological report in accordance with clinical guidelines and the imperative of tailoring decisions based on the patients' and lesions' characteristics and preferences. Moreover, we offer guidance on managing complex scenarios, such as those involving non-curative resection. Finally, we identify future research avenues, including the role of artificial intelligence in estimating the depth of invasion and the urgent need to refine predictive scores for lymph node metastasis and metachronous lesions.
Competing Interests: Declaration of competing interest Enrique Rodríguez de Santiago declares: Olympus (educational activities and advisory), Apollo Endosurgery (educational activities), Norgine (congresses fee and education activities), Adacyte Therapeuthics (advisory activities) and Casen Recordati (congresses fee). Pedro G. Delgado-Guillena declares: Sonoscape (educational activities and advisory), ST Endoscopy (educational activities and congresses fee) and Casen Recordati (congresses fee). The remaining authors declare that there is no conflict of interest.
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