Treatment of Early Oesophageal Cancer (cT1 N0 M0) with Intraepithelial High-Grade Dysplasia or T1 Tumours
This protocol addresses the management of early-stage oesophageal cancer confined to the mucosa or submucosa, without nodal or distant spread — specifically lesions presenting with intraepithelial high-grade dysplasia or most T1 tumours of the oesophagus.
Clinical Scenario
Patients present with early oesophageal cancer staged cT1 N0 M0, including lesions with intraepithelial high-grade dysplasia and most T1 tumours. Endoscopic en bloc resection — using either endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) — is the treatment of choice in this setting. The staging and histological findings after endoscopic resection determine the next management step.
Treatment Approach
For patients in this early-stage group whose endoscopic resection findings indicate specific risk factors, a surgical approach involving further resection may be indicated — though the full criteria, sequencing, and extent of intervention are detailed in the complete protocol.
References
DOI: 10.1016/j.annonc.2022.07.003
Endoscopic en bloc resection, using either endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD), is the treatment of choice for lesions with intraepithelial high-grade dysplasia and most T1 tumours.
For both histological subtypes, patients with involved deep endoscopic resection margins or significant risk factors for lymph node metastases should be offered further resective surgery with appropriate lymphadenectomy [III, A].
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