Endoscopic Management of Early Stage Cancers of the Esophagus and Stomach (DV057)-Endoscopic Management of Early Stage Cancers of the Esophagus and Stomach (DV057)

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Therapeutic endoscopy is an important treatment option for early gastric and esophageal cancers. The two main treatment methods are ablation therapy and endoscopic resection. Endoscopic resection is the preferred method for diagnosis and treatment of superficial GI tumors, and it has similar outcomes to surgery. Ablation therapy can also cure early cancer, but it cannot provide a precise pathological staging of the cancer, which is necessary for further treatment planning. Endoscopic resection requires extensive training and may have more complications compared to biopsy. However, it allows for accurate staging and does not prevent future surgical therapy. Endoscopic resection is recommended by the AG and ASGE for early esophageal and gastric cancers. The goal of endoscopic resection is to achieve curative resection, which means no further treatment is needed. The current indications for endoscopic resection of gastric cancer are limited to certain types and sizes of tumors. Expanded criteria for endoscopic resection, which are still under investigation, include tumors with lower risks of lymph node metastasis. Endoscopic resection of esophageal cancer is mainly limited to mucosal lesions and carries a lower risk of nodal metastasis. Various techniques and tools are used for endoscopic resection, including inject-and-cut EMR, cap-assisted EMR, stepwise radical endoscopic resection, and precut EMR. These techniques have different advantages and limitations. Complications of endoscopic resection include bleeding and perforation, which can usually be managed endoscopically. After resection, a pathological assessment is performed to determine the stage of the cancer and further treatment options. Endoscopic resection has been shown to be highly successful in achieving disease-free survival for early gastric and esophageal cancers, with low rates of recurrence and high 5-year survival rates. Overall, endoscopic resection is a valuable and effective treatment option for early gastric and esophageal cancers.

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Keywords

therapeutic endoscopy

gastric cancer

esophageal cancer

ablation therapy

endoscopic resection

diagnosis

complications

curative resection

lymph node metastasis

mucosal lesions

pathological assessment