How effective is endoscopic therapy in the treatment of patients with early esophageal cancer?

Endoscopic therapy is increasingly used to treat high-grade dysplasia and/or early mucosal adenocarcinoma in patients with Barrett's esophagus. However, no randomized controlled trials have directly compared the efficacy of endoscopic therapy and traditional surgical approaches. This commentary discusses the findings of a retrospective, population-based study by Das et al. that demonstrates the effectiveness of endoscopic resection and/or endoscopic ablation in the treatment of early esophageal cancer. This study used data from the Surveillance Epidemiology and End Results database of the National Cancer Institute to compare cancer-free survival in patients with early esophageal cancer who were either treated with endoscopic therapy (n = 99) or surgical resection (n = 643). Analysis using a Cox proportional hazards model did not reveal a difference in esophageal cancer-specific mortality between the two groups. These results, therefore, support the use of endoscopic therapy in the treatment of early-stage esophageal cancer.