Dr. Molena on Challenges With Endoscopic Resection in Esophageal Cancers

Daniela Molena, MD, director, Esophageal Surgery Program, Memorial Sloan Kettering Cancer Center, discusses what she believes is the Achilles heel of endoscopic resection in patients with esophageal cancer.

According to Molena, the challenge today is the inability to predict nodal disease. It’s unknown whether a patient has nodal disease or not, but tumor characteristics can be used to estimate the risk of nodal disease.

If a patient is at high risk of nodal disease, then it is determined that endoscopic resection is not a good option; instead, they should have a more aggressive approach, such as a pharyngectomy. For those who are considered low risk of nodel disease, endoscopic resection is a safe option, Molena explains. For the future, she says it is necessary to find ways to identify nodal disease in patients without having to predict the risk.

View more from the 2019 Gastrointestinal Cancers Symposium