Xu JH, Liu Y. Organ preservation in esophageal cancer treatment, is it time now? World J Gastroenterol 2025; 31(45): 112287 [DOI: 10.3748/wjg.v31.i45.112287]
Corresponding Author of This Article
Yong Liu, MD, Chief Physician, Department of Thoracic Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26 Shengli Street, Wuhan 430011, Hubei Province, China. liuyong7575@163.com
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Surgery
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Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Dec 7, 2025 (publication date) through Dec 6, 2025
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Publication Name
World Journal of Gastroenterology
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1007-9327
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Xu JH, Liu Y. Organ preservation in esophageal cancer treatment, is it time now? World J Gastroenterol 2025; 31(45): 112287 [DOI: 10.3748/wjg.v31.i45.112287]
World J Gastroenterol. Dec 7, 2025; 31(45): 112287 Published online Dec 7, 2025. doi: 10.3748/wjg.v31.i45.112287
Organ preservation in esophageal cancer treatment, is it time now?
Jia-Hang Xu, Yong Liu
Jia-Hang Xu, Yong Liu, Department of Thoracic Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430011, Hubei Province, China
Author contributions: Liu Y designed the paper and reviewed the manuscript; Xu JH collected and analyzed the data in the references, and wrote the draft.
Conflict-of-interest statement: We declare that we have no conflict of interest.
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: Yong Liu, MD, Chief Physician, Department of Thoracic Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26 Shengli Street, Wuhan 430011, Hubei Province, China. liuyong7575@163.com
Received: July 23, 2025 Revised: August 29, 2025 Accepted: October 27, 2025 Published online: December 7, 2025 Processing time: 134 Days and 0 Hours
Abstract
As esophageal cancer (EC) is a prevalent malignancy of the digestive tract, with esophageal squamous cell carcinoma being its predominant pathological subtype, accounting for nearly 90% of all cases. Current treatment modalities for EC include surgery, chemotherapy, and radiotherapy; however, single-modality therapies are associated with inherent limitations. Advances in endoscopic techniques and the integration of immunotherapy have enhanced the feasibility and safety of organ-preserving strategies for EC. These approaches enable patients to achieve prolonged survival and an improved quality of life. Nevertheless, the criteria for selecting patients suitable for organ preservation require further refinement through active surveillance. The optimal timing for surgical intervention in patients with tumor progression or metastasis remains controversial; however, the "watch and wait" strategy may represent a viable option for selected individuals.
Core Tip: Esophageal cancer (EC) ranks among the most prevalent malignant tumors worldwide. Organ preservation (OP) therapy aims to optimize patient quality of life without compromising survival outcomes. Recent advances in endoscopic techniques and immunotherapy have significantly improved the safety and feasibility of OP strategies for EC. However, the widespread implementation of OP remains limited by several challenges. These include discrepancies between clinical complete response and pathological complete response assessments, uncertainties regarding long-term safety, and the absence of standardized patient selection criteria. Future efforts should focus on enhancing the predictive accuracy of treatment response, optimizing active surveillance protocols, strategically integrating immunotherapy into neoadjuvant frameworks, and validating these approaches through rigorously designed, sufficiently powered, multicenter randomized controlled trials.
