Importance of early detection of esophageal cancer before the tumor progresses too much for effective treatment

Abstract

This editorial comments on an article by Qu et al published in the World Journal of Gastrointestinal Oncology. It focuses on the importance of early detection of esophageal cancer, including recurrence or secondary malignancy after chemoradiotherapy (CRT). Endoscopic resection is the first choice for treatment for esophageal cancer remaining within the mucous membrane, while surgery or radical CRT are treatment options for advanced stages depending on the patient’s general condition and desire. Although these treatments are potentially curative, they are more invasive than endoscopic resection. Early-stage esophageal cancer is often asymptomatic and difficult to detect. Uniform periodic endoscopy is unrealistic. Although less burdensome tests exist, including liquid biopsy and urinary biomarkers, these have not yet been widely used in clinical practice. Early detection is important after radical CRT because the local recurrence rate is higher than that after surgery. However, endoscopic resection or photodynamic therapy is indicated if detected in the early stages, and positive results have been reported. Early detection of esophageal cancer is crucial. Endoscopy is the main diagnostic method; however, new and less burdensome methods should be established to ensure early treatment for patients with esophageal cancer.

Keywords: Esophageal neoplasms; Screening; Endoscopy; Prognosis; Endoscopic mucosal resection; Endoscopic submucosal dissection; Photodynamic therapy

Core Tip: Surgery and chemoradiotherapy (CRT) for esophageal cancer are more invasive than endoscopic resection. However, early esophageal cancer is often asymptomatic and difficult to detect at an early stage. Uniform periodic endoscopy is unrealistic. This is a challenging problem. Regular endoscopy after CRT is also important, and if detected early, a complete cure can be expected with less burdensome endoscopic treatment. Currently, endoscopy is the main diagnostic method, but the hope is that new and less burdensome diagnostic methods will be established to ensure early treatment.