The incidence of lymph node metastasis in early gastric cancer according to the expanded criteria in comparison with the absolute criteria of the Japanese Gastric Cancer Association: a systematic review of the literature and meta-analysis

Japanese criteria for curative endoscopic resection of early gastric cancer initially included non-ulcerated, well-differentiated mucosal lesions ≤2 cm in diameter, known as the absolute criteria. Subsequently, these indications were expanded to include larger, ulcerated and undifferentiated mucosal lesions as well as differentiated lesions with slight submucosal invasion (SM1). Whether patients meeting the expanded criteria (Ex) can be safely managed without gastrectomy and lymph node dissection has been controversial.

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