What is Early Esophageal Cancer?

Early esophageal cancer refers to cancer cells that are confined to the mucosa, the submucosa, or the uppermost part of the third layer of the esophagus. This classification excludes any invasion into the muscularis propria, and is widely accepted across various medical specialties, including surgery, pathology, gastroenterology, oncology, and radiation oncology. The definition may vary slightly depending on the clinical perspective, but the core idea remains consistent—limited tumor spread with minimal risk of metastasis.

From a gastroenterological standpoint, the esophagus is divided into five distinct layers. When cancer affects only the first and second layers, or the upper third of the third layer, it is categorized as early-stage esophageal cancer. This depth of invasion is particularly significant because it allows for minimally invasive treatments such as endoscopic resection, which can effectively reduce the risk of lymph node metastasis.

Studies have shown that the risk of metastasis in first-layer esophageal cancers can be as low as 9%, while overall metastatic risk remains under 25% when the tumor is limited to these upper layers. This has led to a growing preference for less invasive treatment options that offer similar outcomes to traditional surgery but with significantly fewer complications and faster recovery times.

Both international and domestic research supports the effectiveness of minimally invasive endoscopic procedures for treating early esophageal cancer, showing comparable long-term results to open surgical methods. As a result, patients can benefit from reduced trauma, shorter hospital stays, and improved quality of life without compromising survival rates. This shift in treatment approach highlights the importance of early detection and tailored therapeutic strategies in managing early-stage esophageal malignancies.