Long-term outcomes after endoscopic resection for cervical esophageal squamous cell carcinoma

Abstract

Background and aims: Data on long-term outcomes of endoscopic resection (ER) for cervical esophageal squamous cell carcinoma (ESCC) are limited. We investigated long-term outcomes of ER for superficial cervical ESCC by stratifying lesions based on invasion depth and lymphovascular invasion (LVI).

Methods: A total of 131 patients who underwent ER for T1 cervical ESCC were divided into 3 groups based on final pathologic diagnosis: pT1a-EP/LPM without LVI (group A, 103 patients), pT1a-MM without LVI (group B, 10 patients), and pT1a-MM with LVI or pT1b-SM1/SM2 (group C, 18 patients). Overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) were compared among the groups.

Results: The median observation period was 64 months. In groups A and B, none of the patients received additional therapy after ER and none had metastatic recurrence. In group C, 14 of 18 patients received additional chemoradiotherapy (CRT) after ER, whereas the remaining 4 patients did not. Of the 14 patients who received additional CRT, 1 (7%) had local and lymph node recurrence, resulting in cervical ESCC-related death. One of the 4 patients (25%) who did not receive additional CRT had lymph node recurrence, but was salvaged by lymphadenectomy and CRT. The 5-year OS in group A, B, and C was 90%, 100%, and 75% (P = .06), the 5-year DSS was 100%, 100%, and 92% (P = .046), and the 5-year RFS was 90%, 100%, and 69% (P = .02), respectively.

Conclusions: The long-term outcomes following ER for cervical ESCC in this study were comparable to those previously reported for thoracic ESCC in the literature.