Efficacy and Safety of Repeat Endoscopic Submucosal Dissection for Recurrent, Synchronous, and Metachronous Esophageal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

Division

North Florida

Hospital

North Florida Regional Medical Center

Document Type

Manuscript

Publication Date

6-11-2025

Keywords

endoscopic submucosal dissection, early-stage esophageal squamous cell carcinoma

Disciplines

Gastroenterology | Internal Medicine | Medicine and Health Sciences | Neoplasms | Surgical Procedures, Operative

Abstract

BACKGROUND AND AIMS: Endoscopic submucosal dissection (ESD) is the preferred treatment for early-stage esophageal squamous cell carcinoma (ESCC), providing a minimally invasive endoscopic alternative to surgery with potential for complete resection and organ preservation. This study aims to evaluate the efficacy and safety of repeat ESD for recurrent ESCC lesions located on or near previous ESD scars.

METHODS: A systematic search of PubMed, Google Scholar, and Cochrane (From inception till November 2024) identified studies on repeat ESD for recurrent ESCC near previous ESD scars. Primary outcomes were en bloc resection and complete resection (R0). Secondary outcomes included complications (perforation, stricture, bleeding) and recurrence. Meta-analysis was conducted using a random-effects model, and heterogeneity was assessed with I

RESULTS: Five studies with 232 patients (mean age 69.4 years; 85.35% male) and 258 lesions were analyzed. The pooled en bloc resection rate was 90.07% (95% CI: 82.46-95.70, I

CONCLUSION: Repeat ESD demonstrated acceptable clinical outcomes for recurrent ESCC. Despite technical challenges and variability in complications, it seems to be a viable endoscopic option, emphasizing the need for further research to optimize outcomes.

Publisher or Conference

Gastrointestinal Endoscopy

Link to Full Text

Share

COinS