To discuss the choices and early results of endoscopic submucosal dissection(ESD) treatment of muscularis mucosal or submucosal invasion of esophageal squamous cell carcinoma.

The clinical data of patients with esophageal squamous cell carcinoma undergoing ESD surgery in Shanghai Chest Hospital between June 2014 and June 2017 were reviewed. The pathological invasion of 22 cases is the muscularis mucosa or submucosa (T1a-M3-T1b). In 16 cases the lesions were located in the middle esophagus and 6 cases in the lower esophagus. The general information, postoperative complications, comprehensive treatment, and short-term follow-up results were analyzed.

Among 22 cases, 10 cases (45.5%) underwent R0 resection, and 12 cases underwent R1 resection, including 3 cases of basal margin positive, 9 cases of lateral margin positive; there were 9 cases (40.9%) of T1a-M3 of the pathological type of specimens, and 13 cases (59.1%) of T1b. The follow-up time was 0.9-19.9 months, and the median time was 6 months. 3 cases (13.6%) underwent endoscopic dilatation during esophageal stenosis. In 7 patients who were followed up for surgery, 4 patients received salvage surgery (1 case receiving recurrent surgery after 6 months), and 3 patients received radiotherapy and chemotherapy. Surgical resection was associated with depth of tumor invasion (P = 0.0274) and had no correlation with lesion length (P=0.2659).

ESD combined with chemoradiotherapy can be regarded as a good choice for the treatment of superficial esophageal cancer invading into the muscularis mucosa or submucosa. The resection rate is closely related to the depth of tumor invasion, and is not related to the length of the lesion.