Abstract
Endoscopic mucosal resection (EMR) of gastric tumor was commenced in Japan in the 1970s to remove small superfi cial adenocarcinomas. Lymph node metastasis was the only limiting factor for EMR to be a curative treatment, and a number of studies were conducted using the surgical databases to specify gastric lesions that had never metastasized to the lymph nodes. All studies consistently showed that at least small differentiated (D-type) adenocarcinomas confi ned to the mucosal layer without ulceration were free from nodal metastasis.
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