[Pathology of early stage cancer of the gastrointestinal tract : Definition, principles and diagnosis].

BACKGROUND: Early stage cancers of the gastrointestinal tract are malignant tumors that are eligible for local therapy regimens and show an excellent prognosis.

OBJECTIVE: This article explains the histopathological aspects of the various diseases that are covered by this topic.

METHODS: Organ-preserving therapies are discussed according to their locations and under consideration of the current guidelines and the relevant literature.

RESULTS: The exact histopathological evaluation of early cancers of the gastrointestinal tract is of crucial importance. It is the essential basis for all further therapy decisions. In most cases, an option for a local resection is given. In comparison to partial or complete organ resections, local resection is associated with a significantly decreased morbidity and reduced length of hospital stays; however, it must be ensured that local therapies do not become responsible for increased rates of tumor recurrence and progression. Therefore, an optimal risk estimation based on a sophisticated histopathological classification is mandatory. This includes the evaluation of the infiltration depth, grading, lymphovascular invasion and resection margins.

CONCLUSION: Molecular analyses have not yet entered clinical practice. The only exceptions are investigations to detect hereditary diseases. The exact histopathological diagnostic of early gastrointestinal cancers is the basis of an effective and organ-preserving therapy.