Published online Apr 27, 2025. doi: 10.4240/wjgs.v17.i4.103700
Revised: February 25, 2025
Accepted: March 5, 2025
Published online: April 27, 2025
Processing time: 79 Days and 23.3 Hours
Tumor progression in patients with esophageal precancerous lesions (EPLs) or early esophageal carcinoma (EEC) is typically confined in both extent and lo
To determine the effect of endoscopic submucosal dissection (ESD) on efficacy, serum tumor markers (STMs), and 6-month postoperative recurrence rate in patients with either EPL or EEC.
This study initially enrolled 120 patients with EPL or EEC, who were admitted from April 2021 to April 2024. Participants were divided into the control group (60 cases), which underwent thoracotomy, and the research group (60 cases) which received ESD treatment. The comparative analysis involved information regarding the efficacy (dissection area and resection rate per unit time), complications (delayed bleeding, wound infection, esophageal reflux, and postoperative esophageal stenosis), surgery-related parameters (bleeding volume, operation duration, and hospital length of stay), STMs [carcinoembryonic antigen (CEA), carbohydrate antigen 724 (CA724), and tumor-specific growth factor (TSGF)], and the 6-month postoperative recurrence rate of the two groups.
Data indicated statistically higher dissection area and resection rate per unit of time in the research group than in the control group. Meanwhile, the research group demonstrated a notably lower overall incidence rate of complications, bleeding volume, operation duration, and hospital length of stay. Further, the CEA, CA724, and TSGF were markedly reduced in the research group after treatment, which were statistically lower compared to the baseline and those of the control group. Finally, during the follow-up, a comparable 6-month postoperative recurrence rate was determined in the two groups.
ESD is clinically effective and safe for EPL and EEC and can significantly restore abnormally increased levels of STMs.
Core Tip: Studies on the efficacy of endoscopic submucosal dissection (ESD) in treating esophageal precancerous lesions (EPLs) or early esophageal carcinoma (EEC), as well as its effects on serum tumor markers (STMs) and the 6-month postoperative recurrence rate, remains limited. This study included 120 patients with EPL or EEC and compared the clinical outcomes of ESD with thoracotomy. The results indicate that ESD provides significant clinical advantages for these patients, including larger dissection area, higher resection rate per unit time, reduced risk of complications, less intraoperative bleeding, shorter operative duration, and accelerated recovery. Moreover, ESD effectively suppresses abnormal STM levels, such as carcinoembryonic antigen, carbohydrate antigen 724, and tumor-specific growth factor. These results provide comprehensive and robust clinical evidence to support the use of ESD in EPL and EEC management.