Long-Term Outcomes of Endoscopic Submucosal Dissection for Superficial Esophageal Squamous Cell Carcinoma.

Abstract

Simple SummaryEndoscopic submucosal dissection (ESD) was developed to enhance en bloc resections and was applied to esophageal lesions. ESD showed advantages over endoscopic mucosal resection (EMR) regarding the en bloc resection rate, complete resection rate, and local recurrence rate. In this review, we summarize up-to-date reports with 5-year survival after ESD for superficial esophageal squamous cell carcinoma. ESD has shown excellent long-term outcomes for superficial esophageal squamous cell carcinoma with epithelium or lamina propria invasion. ESD would be the first choice for superficial esophageal squamous cell carcinoma without obvious submucosal invasion, although more than three-fourths circumferential resection could induce post-operative stenosis.In this review, we summarize up-to-date reports with 5-year survival after endoscopic submucosal dissection (ESD) for superficial esophageal squamous cell carcinoma. In ESD for the depth of the epithelium (m1) or lamina propria (m2), the 5-year cause-specific survival and 5-year overall survival rates were reported to be 98–100%, and 85–95%, respectively. In cases with submucosal invasion or vascular involvement, additional prophylactic treatment such as chemoradiotherapy or surgery was recommended, and the 5-year cause-specific survival and 5-year overall survival rates were reported to be 85–100%, and 56–84%, respectively. Additional treatment might be too invasive for the elderly or patients with severe comorbidities. The risk of additional therapy should be balanced against the risk of lymph node metastasis, considering the life expectancy of such patients.