Managing crawling-type gastric adenocarcinoma with endoscopic techniques and postoperative monitoring

Abstract

Crawling-type gastric adenocarcinoma is a rare subtype of gastric cancer with diagnostic and therapeutic challenges due to its flat, ill-defined lesions. Advanced diagnostic techniques, such as narrow-band imaging and linear endoscopic ultrasonography, improve detection, but endoscopic submucosal dissection poses a risk of incomplete resection. Despite negative resection margins, vigilant postoperative monitoring is crucial due to the potential for recurrence. This letter highlights the importance of refined diagnostic criteria, individualized treatment approaches, and continuous follow-up to optimize management of this unique gastric cancer subtype.

Keywords: Crawling-type gastric cancer; Endoscopic submucosal dissection; Multiple biopsies; Positive resection margin; Postoperative monitoring; Superficial flat tumor.