Strategic International Session (Panel Discussion) 1(JGES・JSGE・JSH・JSGS・JSGCS)
Sat. November 7th   14:00 - 17:00   Room 9: Portopia Hotel Main Building Kairaku 3
ST-PD1-1_E
 Endoscopic submucosal dissection in Japan and the United States: Differences in etiology, pathology definitions, and resection strategies.
Makoto Nishimura
Memorial Sloan Kettering Cancer Center
There are well-known differences in the etiology of gastrointestinal neoplasms between Japan and the United States (US). For example, most cases of esophageal cancer in Japan are squamous cell cancer, whereas most cases in the US are adenocarcinoma, primarily arising from the background Barrett’s esophagus. There is a huge demand for early gastric cancer treatment in Japan because of the high incidence of H. pylori-associated atrophic gastritis. However, early gastric cancer is exceedingly rare in the US. Besides, pathology definitions differ between the two countries, with “intramucosal cancer” in Japan and “high-grade dysplasia” in the US. For diagnosing carcinoma, Japanese pathologists use a combination of nuclear and architectural abnormalities regardless of the invasion status, which leads to “high-grade dysplasia” in the US tending to be diagnosed as “intramucosal carcinoma” in Japan. To resolve these discrepancies, international meetings were held in 1998, gathering pathologists from both countries, and the Vienna Classification was reported. However, these issues remain.
Other differences include training systems, insurance systems, endoscopic surveillance systems, and anesthesia. In this presentation, these differences will be discussed using the speaker’s experience of endoscopic submucosal dissection in both countries.
Index Term 1: ESD
Index Term 2: Pathology
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