Endoscopic and surgical management of early esophageal cancer: Current evidence and evolving oncologic strategies

Table 5 Stratified treatment considerations based on tumor characteristics

Factor	Category	Clinical implication	Preferred approach
Tumor size	≤ 2 cm	Higher likelihood of en bloc resection	EMR or ESD
	> 2 cm	Increased risk of incomplete resection	ESD preferred
Depth of invasion	M1-M2	Minimal nodal risk	Endoscopic therapy
	M3-SM1	Intermediate nodal risk	ESD ± surgery
Histology	ESCC	Higher nodal risk with invasion	Careful selection
	EAC	Lower nodal risk in early stage	Endoscopic therapy favored

ESD: Endoscopic submucosal dissection; EMR: Endoscopic mucosal resection; ESCC: Esophageal squamous cell carcinoma; EAC: Esophageal adenocarcinoma.