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Comparative Study
. 2025 Jul 11;56(1):150.
doi: 10.1007/s12029-025-01270-4.

Endoscopic Submucosal Dissection Followed by Chemoradiotherapy Versus Radiotherapy in Patients with Stage T1bN0M0 Esophageal Cancer

Yan Lin  1 , Cheng-Xian Ma  2 , Huan-Wei Liang  2 , Wei Huang  2 , Xin-Bin Pan  3
Affiliations
Comparative Study

Endoscopic Submucosal Dissection Followed by Chemoradiotherapy Versus Radiotherapy in Patients with Stage T1bN0M0 Esophageal Cancer

Yan Lin et al. J Gastrointest Cancer. .

Abstract

Purpose: To compare survival outcomes between endoscopic submucosal dissection (ESD) followed by chemoradiotherapy versus radiotherapy in stage T1bN0M0 esophageal cancer.

Materials and methods: Patients with stage T1bN0M0 esophageal cancer between 2000 and 2021 were identified from the Surveillance, Epidemiology, and End Results database. Cancer-specific survival (CSS) and overall survival (OS) were compared between the ESD followed by chemoradiotherapy versus radiotherapy cohorts.

Results: Among 71 eligible patients, 57 (80.3%) received ESD followed by chemoradiotherapy and 14 (19.7%) underwent ESD followed by radiotherapy. Before propensity score matching, ESD followed by radiotherapy demonstrated inferior 5-year CSS (hazard ratio [HR] = 3.27, 95% confidence interval [CI] 1.12-9.58, P = 0.030), but comparable 5-year OS (HR = 1.46; 95% CI, 0.65-3.27; P = 0.362) versus ESD followed by chemoradiotherapy. After propensity score matching, no significant difference in 5-year CSS (HR = 1.76; 95% CI, 0.49-6.34; P = 0.386) or OS (HR = 1.33; 95% CI, 0.48-3.74; P = 0.585) was observed between treatment groups.

Conclusion: ESD followed by radiotherapy provides equivalent CSS and OS compared to ESD followed by chemoradiotherapy in patients with stage T1bN0M0 esophageal cancer.

Keywords: Chemoradiotherapy; Endoscopic submucosal dissection; Esophageal cancer; Radiotherapy; Survival analysis; T1bN0M0.

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Conflict of interest statement

Declarations. Ethics Approval and Consent to Participate: Not applicable. Consent for Publication: Not applicable. Competing interests: The authors declare no conflict of interest.

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