HEALTH PROFESSIONAL · SOURCE READING

Endoscopic mucosal resection (EMR)

Source: Gastric Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.

Source updated: February 21, 2025 · Captured 2026-09-09.

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Context: Treatment of Stage I Gastric Cancer / Treatment Options for Stage I Gastric Cancer

EMR has been studied in Japan and throughout Asia in patients with early-stage tumors with good-risk features (Tis or T1a, diameter ≤2 cm, predominantly differentiated type, without ulcerative findings) that have a lower risk of nodal metastasis. Intramucosal tumors have a lower risk of nodal metastasis than submucosal tumors.[6] Careful patient selection according to risk criteria, treatment with an experienced endoscopist, and close surveillance should be considered.

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Evidence (EMR):

A prospective trial of EMR included 445 patients with intramucosal carcinoma (a total of 479 tumors) treated in Tokyo between 1987 and 1998. Complete resection was recommended for patients with evidence of submucosal invasion, blood vessel involvement, and/or positive margins.[7][Level of evidence C2]

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Of the 405 patients with intramucosal disease, 278 underwent complete resection, with 2% local recurrence treated with curative intent and 100% disease-free survival at a median follow-up of 38 months.

In those with resections that were incomplete or not evaluable, 18 of 127 patients had a local recurrence and underwent curative surgery.

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Preserved source evidence · Not medical advice