Endoscopic Treatment of Early-Stage Esophageal Cancer

Abstract

Purpose of review: Esophageal cancer is a leading cause of global cancer-related mortality. Here, we discuss the major endoscopic treatment modalities for management of early esophageal cancer (EEC).

Recent findings: Advances in endoscopic imaging and therapy have shifted the paradigm of managing early esophageal cancers. Though esophagectomy remains the preferred management for advanced cancers, guidelines now recommend endoscopic resection followed by ablative therapy for early (Tis and T1a) cancers. Available data suggests endoscopic treatment is comparable to surgery with regard to overall and cancer-specific survival with lower procedural morbidity and mortality. Endoscopic modalities are emerging as frontline treatment options for patients with early esophageal cancers. Accurate clinical staging with assessment of disease extent, tumor grade, and risk of nodal metastases is crucial when determining eligibility for endoscopic management of EEC. High-quality routine surveillance endoscopy is critical in patients who have undergone resection and/or ablation.

Keywords: Early esophageal cancer (EEC); Endoscopic mucosal resection (EMR); Endoscopic submucosal dissection (ESD); Esophageal adenocarcinoma (EAC); Esophageal squamous cell cancer (ESCC); Radio frequency ablation (RFA).