SIES SERIES III
Endoscopic detection, characterisation and management of early gastric cancer
Early Gastric Cancer remains a therapeutic conundrum for many endoscopists. New scientific developments now underpin the best practice approach. Prof. Takuji Gotoda from Tokyo, Japan joined the discussion.
In 2021, gastric cancer remains an important cause of mortality in the Western world, more than 1000 Australians will die from it this year. Seen in perspective, this is more than one fifth of the annual mortality from colorectal cancer, the second leading cause of cancer death in Australia.
With the advent of widespread population based screening for colorectal cancer, gastroscopy is also frequently performed for associated upper GI symptoms. Like colorectal cancer, gastric cancer also has precursor lesions which are amenable to early detection and treatment in the pre-invasive stage. Moreover, a significant subgroup of early gastric cancers are suitable for curative endoscopic treatment.
The endoscopist must be aware of the features of both the ‘at risk stomach’ and ‘average risk stomach’ and the standardised approach to routine evaluation. In addition, best practice techniques to characterise the full gambit of lesions, from the very subtle to more advanced pathology need to be embraced.
Takuji GOTODA, MD, PhD graduated from Tokyo Medical University in 1992. After internship, he started his residency for Gastrointestinal Oncology from 1995, and was appointed the Chief of the Endoscopy Division at National Cancer Center Hospital from 2006. He has received the ASGE Audiovisual Award in 2005 and 2010. He has served in the board member of Journal of Gastroenterology & Hepatology, Gastric Cancer and Digestive Endoscopy, and the council of the Japanese Gastric Cancer Association, Japanese Society of Gastroenterology, Japanese Gastroenterological Endoscopy Society and Japanese Society of Gastroenterology. He has also been honoured as a Fellow of ASGE from 2012.
Takuji Gotoda is an ESD (endoscopic submucosal dissection) expert, and has operated more than 500 ESD procedures on stomach or gastric cancer each year. The number of ESD procedures by Prof. Gotoda exceeds most of his peers, which makes him one of the best doctors for gastric cancer despite his young ages. Prof. Gotoda prefers to use the IT knife.