Treatment Trends, Risk of Lymph Node Metastasis, and Outcomes for Localized Esophageal Cancer

This study tracked changes in management for and outcomes of T1a and T1b esophageal cancer using data from the National Cancer Data Base.  Endoscopic resection increased nearly 3-fold to 53% for T1a lesions during the interval, and increased nearly 3-fold to 21% for T1b cancers.  Nodal involvement was predicted by T status, tumor size >2cm, and tumor grade.  The rate of nodal involvement in resected pts was 5% for T1a and 17% for T1b.   Endoscopic therapy had a lower risk of procedure-related mortality (HR 0.33).  5-year survival was better after surgical resection (88% vs 77%).