Soliman YY, Soliman M, Reddy S, Lin J, Kachaamy T. Organ and function preservation in gastrointestinal cancer: Current and future perspectives on endoscopic ablation. World J Gastrointest Endosc 2024; 16(6): 282-291 [DOI: 10.4253/wjge.v16.i6.282]
Corresponding Author of This Article
Youssef Yousry Soliman, MD, Assistant Professor, Department of Gastroenterology, City of Hope Phoenix, 14200 W Celebrate Life Way, Goodyear, AZ 85338, United States. soliman.joe@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Youssef Yousry Soliman, Toufic Kachaamy, Department of Gastroenterology, City of Hope Phoenix, Goodyear, AZ 85338, United States
Megan Soliman, Department of Medicine, Medical Consulting, Goodyear, AZ 85395, United States
Shravani Reddy, Department of Gastroenterology, University of California Irvine, Irvine, CA 92697, United States
James Lin, Department of Gastroenterology, City of Hope National Medical Center, Duarte, CA 91010, United States
Author contributions: Soliman YY, Soliman M, and Kachaamy T created the outline and identified key areas to be addressed; Soliman YY and Soliman M drafted the initial manuscript; Reddy S authored the figures; Reddy S and Lin J contributed to critical review, edits, and improvement in grammatical content; Soliman YY was the corresponding author and incorporated edits and revisions.
Conflict-of-interest statement: Toufic Kachaamy has received fees for serving as a speaker, or consultant for Steris Endoscopy, Olympus, Pentax, Boston Scientific, Medtronic, and Microtech.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Youssef Yousry Soliman, MD, Assistant Professor, Department of Gastroenterology, City of Hope Phoenix, 14200 W Celebrate Life Way, Goodyear, AZ 85338, United States. soliman.joe@gmail.com
Received: February 1, 2024 Revised: March 13, 2024 Accepted: May 6, 2024 Published online: June 16, 2024
Abstract
The escalating prevalence of gastrointestinal cancers underscores the urgency for transformative approaches. Current treatment costs amount to billions of dollars annually, combined with the risks and comorbidities associated with invasive surgery. This highlights the importance of less invasive alternatives with organ preservation being a central aspect of the treatment paradigm. The current standard of care typically involves neoadjuvant systemic therapy followed by surgical resection. There is a growing interest in organ preservation approaches by way of minimizing extensive surgical resections. Endoscopic ablation has proven to be useful in precursor lesions, as well as in palliative cases of unresectable disease. More recently, there has been an increase in reports on the utility of adjunct endoscopic ablative techniques for downstaging disease as well as contributing to non-surgical complete clinical response. This expansive field within endoscopic oncology holds great potential for advancing patient care. By addressing challenges, fostering collaboration, and embracing technological advancements, the gastrointestinal cancer treatment paradigm can shift towards a more sustainable and patient-centric future emphasizing organ and function preservation. This editorial examines the evolving landscape of endoscopic ablation strategies, emphasizing their potential to improve patient outcomes. We briefly review current applications of endoscopic ablation in the esophagus, stomach, duodenum, pancreas, bile ducts, and colon.
Core Tip: Endoscopic ablation of precancerous lesions is widely accepted in the luminal gastrointestinal tract. In unresectable gastrointestinal malignancy, the palliative role of endoscopic ablation is growing. Recently, the prospect of endoscopic ablation is expanding to include downstaging previously unresectable disease, as well as contributing to non-surgical complete clinical response as an adjunct therapy. The prospect for synergy in improving overall survival while balancing the quest for organ and function preservation warrants methodical investigations.
