CURRENT INDICATION AND FUTURE PERSPECTIVE OF ENDOSCOPIC FULL-THICKNESS RESECTION FOR GASTROINTESTINAL STROMAL TUMOR OF THE STOMACH IN JAPAN

Abstract

Gastric submucosal tumors (SMTs) can arise from various tissues of the gastric wall. Of these tumors, gastrointestinal stromal tumors (GISTs) account for 65-80%, which have a malignant nature and require treatment. The advantage of using endoscopic full-thickness resection (EFTR) for intraluminal growth-type GISTs is the ability to preserve organ function by minimizing damage to the gastric wall and extraluminal tissue without corporal incision. The oncological and technical feasibility of EFTR for small GISTs is considered to be high. Accordingly, in September, 2020, endoscopic local resection was approved as the advanced medical care for gastric SMTs that fulfil the following indication criteria: size 11-30 mm, connection to the muscularis propria in EUS, intraluminal growth type, no ulceration, and histologically evident or clinically suspicious (growing tendency, irregular margin, or parenchymal heterogeneity) GISTs. Further prospective studies are warranted to verify the outcomes.