Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2024; 30(10): 1291-1294
Published online Mar 14, 2024. doi: 10.3748/wjg.v30.i10.1291
Nomograms and prognosis for superficial esophageal squamous cell carcinoma
Hong Tao Lin, Ahmed Abdelbaki, Somashekar G Krishna
Hong Tao Lin, Ahmed Abdelbaki, Somashekar G Krishna, Department of Internal Medicine, Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
Author contributions: Lin HT, Abdelbaki A, and Krishna SG wrote the paper; all authors have read and approved the final manuscript.
Conflict-of-interest statement: None of the authors have any relevant conflicts to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Somashekar G Krishna, MD, MPH, FASGE, AGAF, Professor, Department of Internal Medicine, Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 W 12th Avenue, Suite 262, Columbus, OH 43210, United States. somashekar.krishna@osumc.edu
Received: January 2, 2024
Peer-review started: January 2, 2024
First decision: January 19, 2024
Revised: January 28, 2024
Accepted: February 25, 2024
Article in press: February 25, 2024
Published online: March 14, 2024
Processing time: 71 Days and 19.8 Hours
Abstract

In recent years, endoscopic resection, particularly endoscopic submucosal dissection, has become increasingly popular in treating non-metastatic superficial esophageal squamous cell carcinoma (ESCC). In this evolving paradigm, it is crucial to identify factors that predict higher rates of lymphatic invasion and poorer outcomes. Larger tumor size, deeper invasion, poorer differentiation, more infiltrative growth patterns (INF-c), higher-grade tumor budding, positive lymphovascular invasion, and certain biomarkers have been associated with lymph node metastasis and increased morbidity through retrospective reviews, leading to the construction of comprehensive nomograms for outcome prediction. If validated by future prospective studies, these nomograms would prove highly applicable in guiding the selection of treatment for superficial ESCC.

Keywords: Esophageal cancer; Esophageal squamous cell carcinoma; Esophageal resection; Endoscopic mucosal resection; Endoscopic submucosal dissection; Lymph node metastasis

Core Tip: As endoscopic resection becomes the standard of care for non-metastatic superficial esophageal squamous cell carcinoma (ESCC), it is imperative to identify cases with a high risk of lymphatic invasion. Current retrospective studies suggest an association between lymph node metastasis in superficial ESCC and factors such as larger tumor size, deeper invasion, poorer differentiation, more infiltrative growth patterns (INF-c), higher-grade tumor budding, positive lymphovascular invasion, and specific biomarkers. Future prospective studies are required to validate these findings, isolate other prognostic factors and confounders, and establish a more robust causal relationship.