There are two main approaches to endoscopic resection: endoscopic mucosal resection (EMR) and endoscopic submucosal dissection ( ESD).
How do you determine if you have a “clean cut”?
The surgeon will cut off the entire endoscopic submucosal dissection.
The doctor will cut off a complete specimen of esophageal cancer and send it to the pathology department for pathology. The pathology will describe the general shape, location, size, type, depth of infiltration, and margins of the tumor, as well as whether there is lymphovascular and vascular involvement.
The physician makes a definitive determination of the stage of the tumor, the cleanliness of the margins, and the risk of lymph node metastasis to determine whether the resection was clean and whether treatment was successful.
If the postoperative pathology is early-stage esophageal cancer and the surgeon determines that the cancer is clean, the 5-year survival rate is about 85% to 100%. The probability of metastasis or recurrence after 5 years is generally very low and can be interpreted as having been cured.
In rare cases, the pathology shows “undifferentiated early esophageal cancer”. In general, the less differentiated the cancer, the more uncontrolled the growth, the more it deviates from normal cells, and the more malignant it becomes. This type of cancer may grow along the submucosal layer, and it is difficult to guarantee a clean resection by endoscopy. However, please do not worry too much. On the one hand, this kind of case is very rare; on the other hand, the doctor can make follow-up treatment plan based on the pathological results, such as retrospective surgery or radiotherapy.
When do I need a follow-up surgery after endoscopic treatment? Please read:
Dr. Wang Police, Endoscopy Center, Peking University Cancer Hospital