Patients with tumor stage T1 may be candidates for TEM surgery because only 10% of these patients have metastases to the lymph nodes. Cancers of the stage T2 may be candidates for TEM if they have increased operative mortality risk. A local resection of the cancer is of course undesirable, in the lymph node metastases as they are not included in the resection. Distant metastases can with certainty be detected with CT and MRI scans. Preoperative assessment of lymph node involvement is difficult and uncertain for daring to use it to allocate candidates for local resection.