Indications of Endoscopic Submucosal Dissection for Early Gastric Cancer

: Endoscopic submucosal dissection(ESD)has been established as a standard treatment for early gastric cancer with low possibility of lymph node metastasis. Based on the results of the multicenter prospective study(JCOG0607), expanded indication for differentiated-type gastric cancer in Gastric Cancer Treatment Guidelines 2014 changed to absolute indication in Gastric Cancer Treatment Guidelines 2018. The other multicenter prospective study(JCOG1009/1010)will reveal the longterm outcomes of ESD for undifferentiated-type gastric cancer. With the advance of an aging society in Japan, the indication and curability of early gastric cancer for elderly patients should be discussed in the future.