Table 1.
Risk of LNM and recommended treatment of mucosal and submucosal tumors
| Risk of LNM, % | Recommended treatment | |
|---|---|---|
| HGD/mucosal (T1a) | ~1 | EMR/ESD |
| HGD/mucosal (T1a) with high-risk features1 | Not known | EMR/ESD |
| Submucosal (T1b), low risk2 | ≤2 | ESD |
| Submucosal (T1b), high risk3 | 16–444 | Surgical resection |
1
Lymphovascular invasion or poor differentiation.
2
≤500 µm with no histopathologic risk factors.
3
>500 µm or with poor differentiation, lymphovascular invasion, or after non-radical resection.
4
Actual incidence of LNM may be lower; ESD with endoscopic follow-up may be a valid alternative treatment (results of the PREFER study are awaited).