Comparative efficacy and outcomes of different treatments for pathologically high-risk superficial esophageal cancer: a systematic review and network meta-analysis.
Endoscopic resection followed by esophagectomy linked to lower disease-specific mortality than esophagectomy alone
Comparative efficacy and outcomes of different treatments for pathologically high-risk superficial esophageal cancer: a systematic review and network meta-analysis.
Endoscopic resection (endoscopic resection) is increasingly used for superficial esophageal cancer (superficial esophageal cancer), but pathological examination may reveal features associated with lymph-node metastasis or recurrence.
We performed a systematic review and frequentist network meta-analysis according to PRISMA (PROSPERO CRD420251164650).
esophageal cancer deaths were far less likely with resection plus surgery
The OS, recurrence-free survival, and disease-specific survival networks contained 2,621, 2,173, and 1,274 participants, respectively.
Compared with primary esophagectomy (esophagectomy), endoscopic resection followed by esophagectomy (endoscopic resection+esophagectomy) had an OS hazard ratio (HR) of 0.562 (95% CI 0.311-1.015; P = 0.056).
Global inconsistency was not detected for OS or disease-specific survival, whereas the recurrence-free survival network showed significant between-design inconsistency.
Endoscopic resection+esophagectomy was associated with favorable recurrence-free survival and disease-specific survival estimates in selected patients suitable for surgery, with a similar direction of effect for OS.
These findings may support endoscopic resection+esophagectomy as an important post-endoscopic resection treatment option when surgical tolerance is acceptable.
endoscopic resection followed by chemoradiotherapy may represent a clinically relevant organ-preserving strategy, particularly for patients in whom esophagectomy is not preferred or feasible.