Long-term Outcomes After Endoscopic Resection for pMM/SM1 Esophageal Cancer: A Multicenter Prospective Cohort Study.

Authors

Ryu Ishihara, Hiroaki Takahashi, Seiichiro Abe, Toshiyuki Yoshio, Tomonori Yano, Yugo Suzuki, Katsunori Matsueda, Yoichiro Ono, Yoshinobu Yamamoto, Hiroyuki Ono, Noboru Kawata, Waku Hatta, Akiko Takahashi, Ichiro Oda, Yuji Amano, Hideki Ishikawa, Tsuneo Oyama

Published in

The American journal of gastroenterology. Sep 18, 2026. Epub Sep 18, 2026.

Abstract

The optimal management of esophageal cancer with muscularis mucosae or shallow submucosal invasion (post-endoscopic resection [ER] pMM/SM1 cancer) remains controversial. Evidence is largely retrospective, and prospective data are lacking.
This study enrolled patients with squamous cell carcinoma (SCC) or esophageal adenocarcinoma (EAC) diagnosed as post-ER pMM/SM1 cancer. Outcomes included overall survival, metastatic recurrence, local recurrence, and second primary esophageal cancer.
Overall, 385 patients were enrolled, including 315 with SCC and 70 with EAC. Five-year overall survival was 92.3% (95% Confidence interval [CI], 88.8%-94.8%) for SCC and 94.2% (95% CI, 85.4%-97.8%) for EAC. Among post-ER lymphovascular invasion (LVI)-negative patients managed without additional treatment, 5-year survival rates were 94.0% (95% CI, 90.2%-96.4%) for SCC and 93.3% (95% CI, 83.5%-97.5%) for EAC. Cumulative metastatic recurrence rates for LVI-negative SCC were 6.3% (95% CI, 3.0%-12.6%) for pMM and 10.5% (95% CI, 2.6%-33.7%) for pSM1 disease, whereas corresponding rates for EAC were 2.2% (95% CI, 0.3%-13.9%) and 0.0% (95% CI could not be calculated). In LVI-negative SCC, lesion size and macroscopic appearance were independent predictors of metastatic recurrence: type 0-II lesions ≤30 mm had a low cumulative metastatic recurrence rate of 2.9% (95%CI, 1.1%-7.5%). The 5-year cumulative incidence of second primary esophageal cancer was 25.8% for SCC and 3.6% for EAC.
Post-ER pMM/SM1 esophageal cancer is associated with excellent long-term survival. Surveillance is a reasonable option for many LVI-negative cases, although additional treatment may be considered for selected higher-risk patients.

PMID:
42754974
Bibliographic data and abstract were imported from PubMed on 18 Sep 2026.

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