Su1485 Outcomes After Endoscopic Assessment and Management of Early-Stage Esophageal Cancer Uni Wong*, Bruce D. Greenwald Division of Gastroenterology and Hepatology, University of Maryland School of Medicine and Greenebaum Cancer Center, Baltimore, MD; Department of Medicine, University of Maryland Medical Center, Baltimore, MD Early-stage esophageal cancer carries a lower risk of lymph node involvement and metastasis. Endoscopic therapy can be definitive therapy in some cases. High-risk lesions are generally treated with esophagectomy, but some patients are deemed ineligible due to comorbid disease. Limited outcome data is available for this group. Aim: To examine clinical outcomes in patients diagnosed with T1 esophageal cancer presenting at a single institution. Methods: Retrospective review of patients presenting to our institution with stage I esophageal cancer from November 2002 to June 2012. Data collected included age, gender, race, presence and length of Barrett’s esophagus (BE), staging, treatments given (including endoscopic resection [ER], cryotherapy [cryo], esophagectomy [surgery], photodynamic therapy [PDT], or combined chemotherapy and external radiotherapy [CRT]), follow-up duration and outcome. Remission was defined as absence of cancer on biopsy at follow-up EGD. Results: 84 patients were identified. Median age was 70 (range 43-94), 69 (82%) were male, 76 (90%) were diagnosed with adenocarcinoma, and 79 (94%) were white. BE was found in 62 (74%) with median length of 4 cm (range 1-14). Initial ER was performed in 74 (88%). Staging after EUS and ER was T1a-50 (60%) and T1b-31 (37%), not identifiable-3. Median follow-up was 15 months (range 6-115). Other therapy included repeat ER in 22 (26%), cryotherapy in 41 (49%), surgery in 19 (23%), PDT in 5 (6%), CRT in 1 (1%). In the T1a group, 4 patients had surgery, and remission was achieved with endoscopic therapy in 26 (56%), with recurrence in 4. Positive deep margin or lymphovascular invasion was found in 16 (32%) but rate of remission was no different in this group (p 0.07). 1 and 2 year survival is 97.5% and 85%. Only 1 death was directly attributable to esophageal cancer. In the T1b group, surgery was not performed in 16 (51%) due to comorbid illness or patient refusal of surgery. In this group, remission was achieved in 15 with median follow-up of 10 months (range 2-98). Conclusion: Prolonged survival is possible in both T1a and T1b esophageal cancer with endoscopic therapy in those at high risk for complications of esophagectomy. Endoscopic remission is achievable in about half of patients, but death due to cancer progression is uncommon.