Management of esophageal superficial tumors : non take away approaches

Development of screening programs in patients with high risk of developing esophageal cancer, as well as recent advances in diag- nostic endoscopic techniques, have allowed clinicians to improve early detection of esophageal malignant tumors. Surgical resection, although currently considered as the standard of care for patients with early stage esophageal cancer, is sometimes contra-indicated. In this subset of patients, endoscopic resection techniques includ- ing endoscopic mucosal resections (EMR), thermal or non-thermal laser, or cryoablation are amongst the well-recognized modalities safely and efficiently used by gastroenterologists. However, in some patients, these options are contra-indicated or incomplete, necessi- tating medical treatments such as chemotherapy and/or radiation therapy. A systematic search of all the English literature regarding non-take away approaches has therefore been performed, based on a MEDLINE search (Pubmed) carried out between January 1990 and March 2011. Future radiation therapy developments will also be pointed out. (Acta gastroenterol. belg., 2012, 75, 5-8).