General Session 1: Management of Early Stage Esophageal Cancer

Naohisa Yahagi, MD, PhD
Keio University School of Medicine
Endoscopic Management As Definitive Therapy

Conclusion: 

- Endoscopic management of Barrett's cancer is minimally invasive and very effective.

- Targe lesion of endoscopic treatment is T1a and a part of T1b.

- Complete eradication of LSBE is desirable.

- ESD is more reliable than EMR + RFA

Christopher Morse, MD
Massachusetts General Hospital
The Role and Need for Surgical Resection

Conclusion: 

Surgery continues to have a role in early-stage esophageal cancer

- High-risk T1b lesions - Opportunity for lymph node metastasis increased

- LVI/Poor differentiation/Increased depth of invasion

Surgery best accomplished by high volume surgeons at high volume centers

Minimally invasive esophagectomy appears to improve perioperative outcomes

T2N0 - Accurate staging remains a challenge; High-risk lesions identified?/No apparent survival advantage


Michael G. Haddock, MD
Mayo Clinic
Chemoradiation for Early Stage Disease

Conclusion:

Definitive chemoradiation may be an appropriate option for T1bN0M0 esophageal cancer patients who decline surgery

Data is mostly in SQC histology and Asian patients

 

Daniela Molena, MD
Memorial Sloan Kettering Cancer Center
Current and Upcoming Clinical Trials

Reported two trials:

Study Title: Peri-operative Immuno-Chemotherapy in Operable Oesophageal and Gastric Cancer (ICONIC Trial)

ClinicalTrials.gov Identifier: NCT03399071 currently recruiting

Study Title: A Phase II/III Study of Peri-Operative Nivolumab and Ipilimumab in Patients With Locoregional Esophageal and Gastroesophageal Junction Adenocarcinoma

ClinicalTrials.gov Identifier: NCT03604991 not yet recruiting