[Endoscopic diagnostics and treatment of early neoplasia of the esophagus].

Endoscopic diagnostics and treatment of early esophageal neoplasia have achieved considerable progress in recent years. For Barrett's esophagus-associated neoplasia, endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are available, followed by ablation of residual Barrett's epithelium to reduce the risk of metachronous neoplasia. The use of ESD is becoming increasingly more important due to higher en bloc and R0 resection rates and enables precise histopathological diagnostics. For squamous cell neoplasia ESD is the preferred resection technique. After noncurative resection, additional surgical treatment or chemoradiotherapy is recommended; however, emerging data suggest that adjuvant chemoradiotherapy could represent an oncologically equivalent alternative to esophageal resection in selected patients. Current research priorities include optimizing endoscopic screening, including non-endoscopic pretests and artificial intelligence (AI)-based image analysis as well as the extension of organ-preserving treatment concepts through adjuvant treatment strategies.