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Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Sep 16, 2017; 9(9): 438-447
Published online Sep 16, 2017. doi: 10.4253/wjge.v9.i9.438
Endoscopic diagnosis and treatment of early esophageal squamous neoplasia
Yuto Shimamura, Takashi Ikeya, Norman Marcon, Jeffrey D Mosko
Yuto Shimamura, Norman Marcon, Jeffrey D Mosko, Division of Gastroenterology, St. Michael’s Hospital, University of Toronto, Toronto, ON M5B1W8, Canada
Takashi Ikeya, Department of Gastroenterology, St. Luke’s International Hospital, Tokyo 104-8560, Japan
Author contributions: Shimamura Y, Ikeya T, Marcon N and Mosko JD contributed equally to this work; Shimamura Y and Mosko JD provided substantial contribution to conception and design, and wrote the manuscript; Ikeya T and Marcon N provided substantial contribution to acquisition of data, and revising it critically for important intellectual content.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jeffrey D Mosko, MD, Division of Gastroenterology, St. Michael’s Hospital, University of Toronto, 30 Bond Street, Toronto, ON M5B1W8, Canada. moskoj@smh.ca
Telephone: +1-416-8645684
Received: March 3, 2017
Peer-review started: March 7, 2017
First decision: April 17, 2017
Revised: May 14, 2017
Accepted: August 16, 2017
Article in press: August 17, 2017
Published online: September 16, 2017
Processing time: 191 Days and 13.4 Hours
Abstract

Esophageal cancer is one of the leading causes of cancer-related death and is associated with high morbidity and mortality. It carries a poor prognosis as more than half of patients present with advanced and unresectable disease. One contributing factor is the increased risk of lymph node metastases at early stages of disease. As such, it is essential to detect squamous cell neoplasia (SCN) at an early stage. In order to risk stratify lesions, endoscopists must be able to perform image enhanced endoscopy including magnification and Lugol’s chromoendoscopy. The assessment of both the horizontal extent and depth of any lesion is also of utmost importance prior to treatment. Endoscopic mucosal resection and submucosal dissection remain the standard of care with literature supportive their respective use. Radiofrequency ablation and other endoscopic treatments are currently available although should not be considered first line at this time. Our objective is to review the current options for the endoscopic diagnosis and treatment of esophageal SCN.

Keywords: Esophageal squamous cell neoplasia; Image enhanced endoscopy; Esophageal squamous cell carcinoma; endoscopic detection; Chromoendoscopy; Endoscopic mucosal resection; Endoscopic submucosal dissection

Core tip: Esophageal squamous cell carcinoma is one of the leading causes of cancer death. Improving the detection of early stage lesions remains of utmost importance as these lesions can be cured with endoscopic therapy. Endoscopists have many advanced imaging modalities available to assist in risk stratifying lesions. Endoscopic mucosal resection and submucosal dissection remain the standard of care with literature supportive their respective use. Radiofrequency ablation and other endoscopic treatments are currently available although should not be considered first line at this time. As we await improved endoscopic technologies, endoscopists everywhere must remain vigilant in their endoscopic evaluation of the esophagus during each and every endoscopy performed.