Curative endoscopic submucosal dissection for esophageal squamous cell carcinoma after chemoradiotherapy for pharyngeal cancer - A case report

Sep 23, 2026

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Curative salvage endoscopic submucosal dissection (ESD) is evaluated for esophageal squamous cell carcinoma after definitive chemoradiotherapy (dCRT) administered for pharyngeal cancer. Background outlines that ESCC is commonly treated surgically for stage I–III, while dCRT carries recurrence, particularly local residual recurrence rates around 30% in stage I. A Japanese patient in his 70s underwent ESD after tumor response, achieving en bloc curative histology with no recurrence at 22 months. The report concludes ESD may provide a safer curative alternative to high-morbidity esophagectomy in complex malignancy settings.

LanguageEnglish

CategoryHealthcare

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Pages10

Reading Time25 min

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Abstract

Background

Case Summary

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Introduction

| W | J | G | O | World Journal of
Gastrointestinal Oncology | | --- | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastrointest Oncol 2025 April 15; 17(4): 101123 DOI: 10.4251/wjgo.v17.i4.101123 ISSN 1948-5204 (online) CASE REPORT Curative endoscopic submucosal dissection for esophageal squamous cell carcinoma after chemoradiotherapy for pharyngeal cancer: A case report Shion Tachibana, Kentaro Moriichi, Keitaro Takahashi, Masahiro Sato, Yu Kobayashi, Yuya Sugiyama, Takahiro Sasaki, Aki Sakatani, Katsuyoshi Ando, Nobuhiro Ueno, Shin Kashima, Hiroki Tanabe, Mikihiro Fujiya Specialty type: Oncology Provenance and peer review: Unsolicited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade C Novelty: Grade B Creativity or Innovation: Grade B Scientific Significance: Grade B P-Reviewer: Zhang WM Received: September 4, 2024 Revised: January 1, 2025 Accepted: January 21, 2025 Published online: April 15, 2025 Processing time: 202 Days and 1.7 Hours Shion Tachibana, Kentaro Moriichi, Keitaro Takahashi, Masahiro Sato, Yu Kobayashi, Yuya Sugiyama, Takahiro Sasaki, Aki Sakatani, Katsuyoshi Ando, Shin Kashima, Hiroki Tanabe, Mikihiro Fujiya, Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa 078-8510, Hokkaidō, Japan Nobuhiro Ueno, Department of General Medicine, Asahikawa Medical University, Asahikawa 078-8510, Hokkaidō, Japan Corresponding author: Kentaro Moriichi, MD, PhD, Associate Professor, Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahikawa 078-8510, Hokkaidō, [Japan.](Japan. morimori@asahikawa-med.ac.jp)[ morimori@asahikawa-med.ac.jp](Japan. morimori@asahikawa-med.ac.jp) Abstract BACKGROUND Esophageal squamous cell carcinoma (ESCC) is often managed with surgery, which is the first-line treatment option for stage I–III lesions. However, definitive chemoradiotherapy (dCRT) is associated with a recurrence rate of 30% in stage IESCC and higher rates in advanced-staged lesions. However, several patients prefer dCRT because their general condition is poor. Salvage therapies, including esophagectomy and endoscopic resection [endoscopic submucosal dissection (ESD)/endoscopic mucosal resection], are important for residual or recurrent tumors that develop after dCRT. Esophagectomy can have curative potential. However, it has high complication and mortality rates. Therefore, ESD is a safer alternative. CASE SUMMARY A Japanese man in his 70s was concurrently diagnosed with right hypopharyngeal cancer (T2N1M0, cStage III), left oropharyngeal cancer (T1N0M0, cStage I), and left hard palate cancer (T1N0M0, cStage I). Esophagogastroduodenoscopy (EGD) revealed a 20 mm reddish 0-Is+IIb lesion in the upper thoracic esophagus, with an invasion depth of SM2 . The lesion was diagnosed as an esophageal moderately differentiated squamous cell carcinoma (T1bN0M0, cStage I) . As the pharyngeal cancers were in advanced stages, chemoradiotherapy (docetaxel and cisplatin with a radiation dose of 66 Gy) was prioritized. Post-chemoradiotherapy WJGO [https://www.wjgnet.com](https://www.wjgnet.com) 1 April 15, 2025 Volume 17 Issue 4 Tachibana S et al. Salvage ESD for ESCC after CRT EGD showed that the lesion had flattened into a 0-IIb lesion, thereby indicating a reduced invasion depth (epithelium or lamina propria mucosa) . ESD achieved en bloc and histologically confirmed curative resection. At 22 months after ESD, the patient did not present with signs of recurrence. CONCLUSION This case emphasizes that ESD can be successfully utilized as a salvage treatment for ESCC after chemoradiotherapy for otolaryngological cancers. Key Words: Esophageal squamous cell carcinoma; Salvage therapy; Pharyngeal cancer; Otolaryngolo

FAQs

Why is salvage therapy important after definitive chemoradiotherapy for ESCC?

Local residual recurrence after dCRT is substantial, with about 30% in stage I and higher in more advanced stages. Salvage treatments are needed for residual or recurrent tumors.

What treatment strategy was prioritized in this case and why?

Chemoradiotherapy for the advanced pharyngeal cancers was prioritized using docetaxel and cisplatin with a radiation dose of 66 Gy, because the pharyngeal disease was in advanced stages.

What outcomes did the patient have after endoscopic submucosal dissection?

EGD confirmed reduced invasion depth after chemoradiotherapy, and ESD achieved en bloc curative resection. No signs of recurrence were observed 22 months after ESD.

Sep 23, 2026

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