Characteristics of esophageal squamous cell carcinomas resected by endoscopic submucosal dissection based on circumferential localization

Abstract Regarding longitudinal location, esophageal squamous cell carcinoma (ESCC) frequently develops in the middle esophagus. However, few studies have focused on the circumferential location. We examined the frequency and characteristics of ESCC lesions resected by endoscopic submucosal dissection (ESD) regarding both longitudinal and circumferential locations. We retrospectively evaluated 193 ESD-resected ESCC lesions. The ESCC development frequency and histopathological invasion degrees were compared for each circumferential and longitudinal location. Characteristics of the lesions based on location were analyzed, focusing on the proportion of small lesions in the early stages in each location. Twenty-seven lesions were on the anterior wall, 62 on the left, 66 on the posterior, and 38 on the right. Of the four circumferential locations, the median tumor size was the smallest in the anterior wall. The proportions of lesions with an invasion depth of EP and size < 10 mm were the highest in the anterior wall (44.4% and 25.9%, respectively). There was a significant difference between the four circumferential locations for the proportion of ESCC lesions satisfying both criteria, wherein the highest proportion was in the anterior wall (P = 0.049). ESCC of the anterior wall is less frequent and may present as small lesions with shallow depths of invasion.