A retrospective cohort study of endoscopic therapy and esophagectomy for stage 1 esophageal cancer: less is more

Prediction of overall survival in patients with Stage I esophageal cancer: A novel web‐based calculator

“…Furthermore, we found that receiving surgery or local tumor treatment produces analogical results ( p = 0.24) and that patients with EC receiving local tumor treatment tend to have better OS rates (Figure 8). These findings were consistent with the conclusion of McCarty et al, 5 that endoscopic treatment is associated with improved cancer‐specific survival compared with esophagectomy in Stage I EC without lymph node metastasis. Recently, two studies from our center also reported that for patients with early esophageal squamous cell neoplasia, endoscopic treatment is preferred over esophagectomy 6,30 .…”

“…For Stage I EC, surgical resection, which could facilitate broader resection margins and lymphadenectomy, could result in increased long‐term disease‐free survival; nonetheless, local therapy (i.e., local tumor treatment), such as endoscopic treatment, could offer similar outcomes with decreased long‐term morbidity 4–6 . Recently, a study based on the Surveillance, Epidemiology, and End Results (SEER) database reported that endoscopic treatment is associated with a higher cancer‐specific survival rate than esophagectomy ( p < 0.001) in Stage I EC 5 . However, the study regarded Stage I EC as T1a and T1b tumors without lymph node metastases and squamous cell carcinoma with T1 + N1 was not included.…”

Response

“…We have some questions and comments regarding the review by Chandan et al 1 First, Chandan et al 1 included a duplicate study. 2 After contacting Ji et al 2 (whose study was published as an abstract) for further information, we found that they reported data overlapping with the trial by Gweon et al 3 Moreover, an abstract study is not typically peer reviewed and may be of lower quality than fully peer-reviewed articles. We think these may affect the final results.…”

“…We thank Drs Motomura and colleagues 1 for their comments regarding our editorial to the studies by McCarty et al 2 and Otaki et al 3 related to endoscopic therapy for T1b submucosal esophageal cancer. We agree with their statement that multiple risk factors have been shown to progressively increase the risk for lymph node metastases in patients with T1b adenocarcinoma.…”

When less is just less: endoscopic therapy for submucosal T1b esophageal cancer

“…In the second article, McCarty et al 17 used the Surveillance, Epidemiology, and End Results (SEER) database to evaluate the outcome of endoscopic therapy versus esophagectomy for stage 1 esophageal cancer. Their analysis included both squamous and adenocarcinoma patients with clinically staged intramucosal and submucosal tumors.…”