Esophageal cancer, when detected at an early stage, has a very good probability of being eradicated by surgery or
radiotherapy. However, less aggressive treatments also tend to provide high rates of cure without the side effects of radical surgery or
radiotherapy. Among them,
photodynamic therapy and endoscopic mucosal resection have been experienced as alternative techniques for mucosal ablation in patients with superficial
squamous-cell carcinoma (SCC) of the esophagus, or high-grade dysplasia and early stage
adenocarcinoma arising in
Barrett's esophagus. We report on the results of our clinical experience with
photodynamic therapy and discuss about its advantages and limitations. We also present a pre-clinical study, which had evaluated the feasibility, efficacy, and safety of a promising new method of endoscopic mucosal resection (EMR) based on the use of a modified rigid
esophagoscope. The animal model chosen was the sheep because of its similarities with humans regarding the thickness and histologic structure of the esophagus. This new resection modality offers a promising approach in comparison with other options currently available, namely EMRs performed with flexible
gastroscopes. It appears to be superior in terms of the size of the resected specimen, the precision and regularity of the resection depth, and the accuracy of histological diagnosis with safety margins.