Endoscopic Submucosal Dissection for Treatment of Early-Stage Cancer or Precancerous Lesion in the Upper Gastrointestinal Tract in Patients with Liver Cirrhosis

Sep 24, 2026

Uploaded by Jasmine

Endoscopic submucosal dissection (ESD) is established for early-stage upper gastrointestinal cancers, but liver cirrhosis can complicate treatment due to coagulation dysfunction, gastroesophageal varices, and other clinical challenges. This study aimed to evaluate safety and efficacy in cirrhotic patients undergoing ESD for early-stage cancer or precancerous lesions. Eight patients were treated from April 2019 to April 2023 with successful resections, limited complications, and no observed recurrence during 3–45 months follow-up. The findings support ESD as a safe and effective option in this population.

LanguageEnglish

CategoryHealthcare

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Pages11

Reading Time28 min

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Abstract

Introduction

Article Endoscopic Submucosal Dissection for Treatment of Early-Stage Cancer or Precancerous Lesion in the Upper Gastrointestinal Tract in Patients with Liver Cirrhosis Yuyong Tan 1,2,3,†, Yumin Qing 1,2,3,†, Deliang Liu 1,2,3 and Jian Gong 1,2,3, * Citation: Tan, Y.; Qing, Y.; Liu, D.; Gong, J. Endoscopic Submucosal Dissection for Treatment of Early-Stage Cancer or Precancerous Lesion in the Upper Gastrointestinal Tract in Patients with Liver Cirrhosis. J. Clin. Med. 2023, 12, 6509. [https://](https://)[ ](https://)[doi.org/10.3390/jcm12206509](doi.org/10.3390/jcm12206509) Academic Editors: Stanley W. Ashley and L¡szlâ Czakã Received: 21 August 2023 Revised: 15 September 2023 Accepted: 12 October 2023 Published: 13 October 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha 410011, China; [tanyuyong@csu.edu.cn](tanyuyong@csu.edu.cn) (Y.T.); [qingyumin@csu.edu.cn](qingyumin@csu.edu.cn) (Y.Q.); [deliangliu@csu.edu.cn](deliangliu@csu.edu.cn) (D.L.) 2 Research Center of Digestive Disease, Central South University, Changsha 410011, China 3 Clinical Research Center for Digestive Disease in Hunan Province, Changsha 410011, China * [Correspondence: jiangong001@csu.edu.cn](Correspondence: jiangong001@csu.edu.cn) † These authors contributed equally to this work. Abstract: (1) Background: Endoscopic submucosal dissection (ESD) has been widely accepted as the standard method for treating early-stage cancer or precancerous lesions in the upper gastrointestinal tract; however, it may be difﬁcult in patients with liver cirrhosis due to clinical challenges such as coagulation dysfunction, presence of gastroesophageal varices, etc. We aimed to demonstrate the safety and efﬁcacy of ESD in these populations. (2) Methods: The clinical data of patients were retrospectively collected and analyzed. Inclusion criteria of the study were: a. patients with liver cirrhosis; b. patients who underwent ESD; c. patients who were diagnosed with early-stage cancer or precancerous lesions in the upper gastrointestinal tract. (3) Results: Eight patients were enrolled from April 2019 to April 2023, of whom three were male and ﬁve were female, with ages ranging from 43 to 70 years old. Seven lesions were located in the stomach and one other lesion was in the esophagus. ESD was performed successfully in all eight patients, and the resected lesion size ranged from 2 to 6 cm. Only one patient encountered postoperative complications, namely, chest pain and fever. No recurrence was noticed during a follow-up of 3 to 45 months. (4) Conclusions: ESD may serve asa safe and effective method for treating upper gastrointestinal early-stage cancer or precancerous lesions in patients with liver cirrhosis. Keywords: early-stage cancer; precancerous lesion; endoscopic submucosal dissection; liver cirrhosis 1. Introduction Esophageal and gastric cancers, which we call upper gastrointestinal cancers, are two of the most common cancers around the world with high incidence (ranking eighth and ﬁfth among all cancers, respectively) and mortality (ranking sixth and fourth among all cancers, respectively) rates, especially in Asian countries such as China, Korea, and Japan [1] . The overall 5-year survival rates of advanced esophageal and gastric cancer are lower than 30% even after comprehensive therapy such as surgery, chemotherapy, immunotherapy, etc., while the rates exceed 90% when found at an early stage and treated timely [2,3] . With the development of patients' awareness and equipment of cancer screening, more and more early-stage cance

FAQs

Why can ESD be difficult in patients with liver cirrhosis?

ESD may be challenging because cirrhosis is associated with coagulation dysfunction, gastroesophageal varices, tissue vulnerability, and higher risk of related clinical complications.

How was the study conducted and who was included?

Clinical data were retrospectively collected. Patients were included if they had liver cirrhosis, underwent ESD, and were diagnosed with early-stage cancer or precancerous lesions in the upper gastrointestinal tract.

What were the main outcomes after ESD?

All eight patients underwent successful ESD with resected lesion sizes between 2 and 6 cm. Only one patient experienced postoperative complications, and no recurrence was observed during follow-up.

Sep 24, 2026

Uploaded by Jasmine