The diagnosis and therapy of early carcinomas of the gastrointestinal tract represents a particular endoscopic challenge for the gastroenterologist. By definition, early carcinomas are amenable to curative treatment or at least to a substantially better overall prognosis than in patients with more advanced disease. Besides the imperative of detecting early carcinomas at a correspondingly early stage, there is the unrestricted requirement to treat these entities according to oncological criteria. With the exception of cases with especially high comorbidity, treatment may consist of a relatively limited surgical procedure. Endoscopy must in each case live up to these demands. In general, we are dealing here with carcinomas of stage Tl. Within this stage, however, there is a variable risk of developing lymph node metastases, which affects overall prospects of cure. This risk is affected by localization, as well as by histological type and the tumour's macroscopic appearance, lateral spread and depth of infiltration. Finally, the endoscopic resection technique is of crucial importance in determining the success of any local therapy.
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