Endomicroscopy in Early Oesophageal Squamous Cell Neoplasias

Abstract

The incidence of squamous cell cancer of the oesophagus has decreased in Western countries over the past few years, it being 4–16/100 000 depending on geographical location, with higher rates in Asia [1]. When oesophageal cancer is limited to the mucosa, endoscopic therapy using endoscopic resection (ER) or photodynamic therapy (PDT) can be performed with curative intent [1]–[4]. ER has been established as a standard treatment for patients with early squamous cell neoplasia during the past several years. Several reports, first from Asia but recently from Western countries, have revealed promising results, especially when cancerous tissue is limited to the mucosa (m1–m3) [4, 5]. These patients with limited disease have a very low risk for lymph node metastasis and can be cured by endoscopic therapy. In contrast, in cases of submucosal invasion, the rate of lymph node malignancy rises to 50% and the outcome after ER is poor [4, 6].