Background: Endoscopic resection (ER) provides a minimally invasive treatment option for early gastrointestinal cancers.
Objective: Presentation of current guideline recommendations. Presentation and discussion of published data regarding ER of early esophageal cancer, early gastric cancer and early colorectal cancer.
Material and methods: Analysis of the current literature. Presentation of endoscopic case reports.
Results: New technologies, e. g. narrow-band imaging (NBI) have improved the endoscopic diagnosis of early gastrointestinal neoplasms. The development of endoscopic submucosal dissection (ESD) allowed higher R0 resection rates and minimized the recurrence risk leading to higher rates of curative endoscopic resection. Resection criteria are defined in national and international guidelines. Resection criteria for early gastric cancer are different between German (guideline criteria) and Asian guidelines (expanded criteria). New German data did not show a difference in long-term survival after ESD of early gastric cancers fulfilling the guideline criteria or the expanded criteria. In early colorectal cancer submucosal invasion exceeding 1000 µm is defined as the limit for ER in current guidelines. This threshold might be too strict for subgroups without further risk factors but further data are awaited.
Conclusion: Substantial progress has been made in endoscopic diagnostics and treatment of early gastrointestinal cancers. First European data could confirm previous Asian results; however, further studies are urgently needed for a better definition of the possibilities and limitations of ER.
Keywords: Early colorectal cancer; Early esophageal cancer; Early gastric cancer; Resection criteria; Submucosal dissection.