Contemporary issues in endoscopic resection for esophageal squamous cell cancer

Jin et al. (1) reported their experience with endoscopic resection (ER) versus minimally invasive esophagectomy (MIE) for 99 consecutively treated patients with early, clinically staged esophageal cancer (T0–T1b). In this retrospective analysis, 59 patients underwent ER and 40 had MIE. The majority of patients (85.9%) had squamous cell carcinoma (SCC). There were no statistically significant differences in the R0 resection rate (their primary endpoint) or in local recurrence rate (their secondary endpoint). Regarding adverse events (their tertiary endpoint), patients who underwent ER had a lower rate of minor complications compared to those who underwent MIE (11.8% vs. 32.5%, respectively, P<0.05), although there was no significant difference in major complications. Patients who underwent ER also had shorter inpatient length of stay (LOS) compared to those who had MIE (average LOS of 6 vs.19 days, respectively, P<0.001). Thus, the authors concluded that for early stage esophageal cancer, mainly of SCC histology, ER offers several post-operative advantages while providing similar oncologic benefits to MIE.