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33

NCCN Guidelines for Patients

®

Esophageal Cancer, Version 1.2016

4

Overview of cancer treatments Endoscopic treatment

Sometimes EMR is all that is needed to remove

a tumor. Other times, the tissue removed by EMR

helps with diagnosis but more treatment is needed.

Some tumors may be removed in multiple pieces with

EMR. However, the larger and deeper a tumor is, the

higher the risk of the tumor returning (recurrence).

Therefore, an expert endoscopist will only perform

EMR on people who are most likely to benefit.

EMR requires that you be sedated but some people

do receive general anesthesia. The procedure can

take about 1 hour to complete. EMR is generally an

outpatient procedure. However, you may stay in the

hospital for 1 or 2 days.

ESD

ESD (

e

ndoscopic

s

ubmucosal

d

issection) is a newer

type of endoscopic treatment that is more extensive

than EMR. It is likely the preferred method for

removing deeper, early esophageal tumors.

ESD removes a tumor in one piece with special

knives. Removing the tumor in one piece reduces

the chance of the tumor returning. This is a very

challenging procedure to do. ESD is generally only

done at centers that specialize in such procedures.

Only a small group of people with esophageal cancer

are able to have this treatment.

ESD is often performed under general anesthesia.

The procedure may take 2 to 4 hours to complete.

You may stay in the hospital for a few days or up to 5

days if there are major complications like a tear in the

esophageal wall. After healing, your esophagus will

likely work almost as well as before since only the first

layer of the esophageal wall is removed.

Figure 10.

Endoscopic resection

Esophageal tumors that have

not invaded deep into the

esophageal wall may be removed

with endoscopic resection.

This treatment removes tumors

with tools inserted through an

endoscope.

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