Treatment choices after endoscopic resection for pMM/SM1 esophageal squamous cell cancer: a retrospective study in China.

BACKGROUND

Treatment choices for patients with pathological muscularis mucosa/submucosal layer (pMM/SM1) esophageal squamous cell cancer (ESCC) after endoscopic resection (ER) are controversial.

MATERIALS AND METHODS

A single-center retrospective study at Beijing Cancer Hospital in China was conducted. Between February 2012 and November 2023, we retrospectively recruited patients with pMM/SM1 ESCC who underwent ER with or without subsequent adjuvant therapy. Survival was compared between groups.

RESULTS

Overall, 93 patients were screened, and 73 patients were included. Kaplan‒Meier analysis revealed that a length of invasive cancer ≤ 10 mm (OS, P = 0.025; DFS, P = 0.059) was a high-risk factor. Compared with the follow-up group, patients who underwent radical surgery (SR) immediately after ER demonstrated significantly shorter overall survival (OS) and disease-free survival (DFS) (OS, P < 0.01; DFS, P < 0.001). High-risk patients (pMM/SM1 patients with an invasive cancer length ≤ 10 mm) may benefit from chemoradiotherapy (CRT), but low-risk patients may not.

CONCLUSION

The length of invasive cancer ≤ 10 mm may be a newly identified high-risk factor. CRT after ER is recommended for high-risk patients but not for low-risk patients. SR is not recommended for any patient.