Esophageal cancer limited to the mucosa and low-risk submucosal adenocarcinoma, are associated with a low risk of lymph node and distant metastasis. For these early esophageal cancers, endoscopic treatment has evolved as a minimally invasive and organ preserving alternative to surgery. Endoscopic resection (ER) is the cornerstone of endoscopic therapy. ER not only removes neoplastic lesions, it also provides a substantial tissue specimen enabling accurate histological staging. Histological assessment of infiltration depth, grade of differentiation and presence of lymphovascular invasion are crucial in selecting patients who are eligible for further endoscopic management.
In patients with early adenocarcinoma arising in Barrett’s esophagus, a number of techniques are available to eradicate all Barrett’s mucosa after focal removal of early neoplastic lesions. Removal of all residual Barrett’s mucosa is advised to minimize the risk of metachronous lesions during follow-up.
In this book chapter we will give an overview of the indications for endoscopic treatment, different techniques that are available for endoscopic resection, management of the patient after focal removal of early cancer, and future perspectives on the place of endoscopic treatment for early esophageal cancer.
Esophagus Cancer Early Endoscopic treatment
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