Endoscopic Techniques in Esophageal Squamous Cell Carcinoma
Summary
The diagnosis and treatment of esophageal squamous cell carcinoma (ESCC) have been transformed by advances in endoscopic techniques. Early lesions confined to the mucosa or superficial submucosa can now be managed with endoscopic resection, avoiding the morbidity of oesophagectomy. Endoscopic mucosal resection (EMR) first established the feasibility of removing discrete mucosal neoplasms. Endoscopic submucosal dissection (ESD) advances this approach by enabling en bloc removal of larger or ulcerated lesions, improving histological assessment and reducing recurrence. High-resolution imaging, including narrow-band imaging and endoscopic ultrasonography, refines the delineation of tumour margins and depth of invasion. Combined-modality strategies have emerged, such as ESD followed by chemoradiotherapy for lesions with high-risk features or positive margins, enhancing locoregional control while preserving organ function. Novel traction devices, intralesional injection platforms and artificial intelligence-assisted detection promise to heighten precision and safety. Ablative therapies, notably photodynamic therapy and radiofrequency ablation, offer salvage options for residual or metachronous lesions. Taken together, these endoscopic innovations underpin a shift towards tailored, minimally invasive management of ESCC with sustained efficacy and improved patient quality of life.
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Endoscopic Techniques in Esophageal Squamous Cell Carcinoma publication trend
The graph below shows the total number of articles in endoscopic techniques in esophageal squamous cell carcinoma across all publications each year (not limited to Nature Index journals).
Technical terms
Endoscopic mucosal resection (EMR): A technique to excise superficial mucosal lesions using a snare after submucosal lifting.
Endoscopic submucosal dissection (ESD): An advanced procedure permitting en bloc removal of larger lesions via submucosal dissection.
Curative resection: Complete tumour removal with clear histological margins and absence of high-risk features.
Chemoradiotherapy (CRT): Combined chemotherapy and radiotherapy used as primary or adjuvant treatment.
Lymph node metastasis: Cancer spread from the oesophagus to regional lymphatic nodes.
Organ preservation strategy: A treatment paradigm aiming to avoid oesophagectomy by combining endoscopic and non-surgical modalities.
References
- Endoscopic submucosal dissection for early esophageal squamous cell carcinoma: long-term results from a Western cohort. Endoscopy (2024).
- Synchronous Head and Neck Cancer and Superficial Esophageal Squamous Cell Neoplasm: Endoscopic Treatment or No Treatment for the Superficial Esophageal Neoplasm. Cancers (2023).
- Treatment strategy for early-stage esophageal cancer. Japanese Journal of Radiology (2024).
- The effectiveness of endoscopic submucosal dissection followed by chemoradiotherapy for superficial esophageal cancer. Radiation Oncology (2015).
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