As a consequence, indications for ESD have been expanded. In a large series Gotoda found no lymph node involvement in the stomachs of patients with well differentiated intestinal mucosal gastric cancer without ulcers no size limit, in patients with ulcers in lesions smaller than 30 mm, and in patients with well-differentiated submucosal cancer limited to sm1 of less than 30 mm in diameter.
Gotoda, en una gran serie, no encontró compromiso linfonodal en estómago en pacientes con cáncer intestinal mucosal bien diferenciado sin úlceras sin límite de tamaño o con úlceras en lesiones menores de 30 mm, ni en cáncer submucosal bien diferenciado, limitado a sm1 con menos de 30 mm de diámetro.