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Management of Esophageal Squamous Cell Neoplasia

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Abstract

Purpose of review

This article reviews the most recent advances regarding the diagnosis and endoscopic treatment of superficial esophageal squamous cell neoplasia.

Recent findings

The incidence of superficial esophageal squamous cell carcinoma (ESCC) has increased mainly because of improvement in endoscopic detection. It is estimated that high-definition white light endoscopy has low sensitivity for the detection of ESCC. Lugol’s iodine chromoendoscopy significantly improves the diagnosis, but with a low specificity. Recently, magnifying endoscopic assessment of the intrapapillary capillary loops has been shown to accurately predict the depth of invasion and therefore guide the best treatment choice. Consequently, management of neoplasms of the esophagus has changed in recent years as endoscopic resection techniques have gradually become more important.

Summary

For superficial ESCC, endoscopic submucosal dissection is considered the preferred approach, enabling accurate en bloc resection with a lower recurrence rate and improved survival. Although some studies have shown promising results for endoscopic resection of submucosal tumors, there are limitations and surgery continues to be the standard treatment for more advanced lesions, either alone or in combination with chemoradiotherapy.

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Authors and Affiliations

  1. Instituto Do Câncer Do Estado de São Paulo (ICESP), , Department of Gastroenterology of the Medical School of the University of São Paulo, Av. Doutor Arnaldo, 251, São Paulo, 01246-000, Brazil

    Renata Nobre MD, PhD & Fauze Maluf-Filho MD, PhD, FASGE

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  1. Renata Nobre MD, PhD
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  2. Fauze Maluf-Filho MD, PhD, FASGE
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Contributions

All authors contributed to the study conception and design. The first draft of the manuscript was written by Renata Nobre and Fauze Maluf-Filho commented on previous versions, read and approved the final manuscript.

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Correspondence to Renata Nobre MD, PhD.

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Renata Nobre declares that she has no conflict of interest.

Fauze Maluf-Filho declares that he has no conflict of interest.

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Nobre, R., Maluf-Filho, F. Management of Esophageal Squamous Cell Neoplasia. Curr Treat Options Gastro 21, 295–306 (2023). https://doi.org/10.1007/s11938-023-00423-3

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