Surgical and Postoperative Management of Esophageal Squamous Cell Carcinoma

Esophageal squamous cell carcinoma is predominantly managed by radical resection, typically via transthoracic or minimally invasive approaches with an extended lymphadenectomy to achieve clear margins and address regional nodal disease. Reconstruction is most often performed with a gastric conduit, although colon interposition may be used when gastric tissue is unsuitable. Enhanced recovery protocols aim to reduce perioperative morbidity, but complications such as anastomotic leak, pulmonary infection and nutritional insufficiency remain significant concerns. Postoperative management balances surveillance for locoregional and distant relapse with the judicious use of adjuvant therapy. Chemotherapy, radiotherapy and combined chemoradiotherapy have all been shown to reduce recurrence and improve survival in selected patient subgroups, notably those with lymph node–positive or advanced-stage disease. Risk stratification based on tumour stage, anatomical location and molecular biomarkers is increasingly employed to personalise both the extent of nodal irradiation and the choice of systemic agents. Emerging techniques—such as deep learning–augmented imaging and refined radiotherapy target definition—promise further gains in treatment precision, minimising toxicity while maximising oncological control.

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Surgical and Postoperative Management of Esophageal Squamous Cell Carcinoma publication trend

The graph below shows the total number of articles in surgical and postoperative management of esophageal squamous cell carcinoma across all publications each year (not limited to Nature Index journals).

Technical terms

Adjuvant therapy: Treatment (chemotherapy, radiotherapy or chemoradiotherapy) administered after surgical resection to eliminate microscopic disease and reduce recurrence risk.

Locoregional recurrence: Return of cancer at the primary site or regional lymph nodes following initial treatment.

PET/CT: Combined imaging technique that overlays metabolic activity from positron emission tomography with anatomical detail from computed tomography.

Deep learning: Advanced machine-learning method using layered neural networks to identify complex patterns within large datasets.

References

1. PET/CT deep learning prognosis for treatment decision support in esophageal squamous cell carcinoma. Insights into Imaging (2024).
2. Risk factors for postoperative recurrence of pT2-3N0M0 esophageal squamous cell carcinoma and patterns of its recurrence. BioScience Trends (2023).
3. A phase-II/III randomized controlled trial of adjuvant radiotherapy or concurrent chemoradiotherapy after surgery versus surgery alone in patients with stage-IIB/III esophageal squamous cell carcinoma. BMC Cancer (2020).
4. Mapping patterns of metastatic lymph nodes for postoperative radiotherapy in thoracic esophageal squamous cell carcinoma: a recommendation for clinical target volume definition. BMC Cancer (2019).
5. Tissue‐based quantitative proteomics to screen and identify the potential biomarkers for early recurrence/metastasis of esophageal squamous cell carcinoma. Cancer Medicine (2018).
6. Neoadjuvant or adjuvant therapy for resectable esophageal cancer: a systematic review and meta-analysis. BMC Medicine (2004).