Endoscopic resection of oesophageal gastrointestinal stromal tumours: Promise, pitfalls and the path forward.

Abstract

Oesophageal gastrointestinal stromal tumours are rare, anatomically challenging lesions with higher surgical morbidity than their gastric counterparts. Emerging endoscopic resection techniques such as endoscopic submucosal dissection and submucosal tunnelling endoscopic resection show much promise for the management of patients who are not fit for, or wish to avoid the morbidity of, major surgical resection. These techniques require careful patient selection and advanced technical skills. We build on the recent review of such techniques by Vogli et al. Current evidence is limited to small case series with heterogeneity in patient selection, tumor size, and outcomes. Notably, long-term oncological data remain sparse, and complications such as bleeding or perforation may be life-threatening in patients unfit for surgical rescue. Nonetheless, endoscopic approaches have many potential advantages to offer such as preserved quality of life and definitive management of unfit patients.