Early detection, diagnostics, and endoscopic therapy of early esophageal neoplasia

Local endoscopic therapy of early esophageal neoplasia gains more and more importance. The fast development of endoscopic technology, new diagnostic methods like chromoendoscopy and miniprobe endosonography in combination with a dramatic increase in the incidence of Barrett's carcinomas lead to a more frequent diagnosis of early stage neoplasias. Therefore, in the last years, local endoscopic therapy like endoscopic mucosal resection or photodynamic therapy is performed more and more often, in case of intraepithelial neoplasias or carcinomas that are limited to the mucosa, as an alternative to radical surgical therapy. Regarding early Barrett's carcinoma, local endoscopic therapy nearly took the place of esophageal resection as the gold standard; however, in the case of early mucosal squamous cell cancer of the low-risk type, results of further studies are needed.