Work

Analysis of risk factors for disease recurrence after endoscopic submucosal dissection of early esophageal cancer

Year: 2025

Type: article

Abstract: BACKGROUND Endoscopic submucosal dissection (ESD) is a minimally invasive, safe, and efficient treatment technique for patients diagnosed with early esophageal cancer. However, postoperative disease recurrence remains an important clinical challenge because it negatively alters patient prognosis and quality of life. As such, identification of relevant risk factors for recurrence can help optimize postoperative management strategies. AIM To assess factors that contribute to the risk for disease recurrence after ESD for early esophageal cancer. METHODS Clinical data from 210 patients diagnosed with early stage esophageal cancer, who underwent ESD at the authors’ center between March 2012 and March 2025, were retrospectively collected and analyzed. Patients were categorized into 2 groups according to postoperative disease recurrence: Recurrence (n = 30), and without recurrence (n = 180). Disease recurrence was defined as the appearance of new tumor lesions or pathologically confirmed tumor recurrence during the postoperative follow-up period. Risk factors associated with postoperative recurrence were identified using univariate and multivariate logistic regression analyses. RESULTS During the follow-up period, 30 patients experienced tumor recurrence, corresponding to a recurrence rate of 14.19%. Multivariate analysis revealed that poor differentiation was a significant potential cause of esophageal cancer recurrence [odds ratio (OR) = 1.782, 95% confidence interval (CI): 1.154-2.196; P < 0.001]. Tumors infiltrating the submucosa were more likely to recur than those penetrating the lamina propria or muscularis mucosa (OR = 1.573, 95%CI: 1.073-2.481; P < 0.001). Furthermore, inability to completely resect the tumor greatly increased the likelihood of recurrence (OR = 2.189, 95%CI: 1.193-3.125; P = 0.001). Tumor diameter ≥ 2 cm was an independent risk factor for postoperative recurrence (OR = 1.981, 95%CI: 1.482-2.862; P = 0.005). CONCLUSION Recurrence of early esophageal cancer after ESD is largely influenced by the degree of differentiation, depth of lesion invasion, complete resection status of the tumor, and tumor diameter.

Source: World Journal of Gastrointestinal Surgery

DOI: 10.4240/wjgs.v17.i12.111714

Authors: Yan-Mei Yang, Ting Dai, Ling-Yu Zou, Cheng-Jin Zhao

Institution: Southeast University

Language: English

Topic: Esophageal Cancer Research and Treatment

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funder: National Natural Science Foundation of China