# Impact of waiting time for treatment on the progression of superficial esophageal squamous cell carcinoma: a single-center retrospective study

## TL;DR

The study found that waiting up to three months before treatment for a specific type of esophageal cancer does not affect long-term survival or diagnostic accuracy.

## Contribution

The study identifies a 3-month acceptable waiting period for superficial esophageal squamous cell carcinoma classified as B1 vessels.

## Key findings

- Diagnostic accuracy remained stable for B1 lesions across all waiting intervals.
- B2 lesions showed high stability within three months of waiting.
- Five-year survival rates were unaffected by waiting periods in both B1 and B2 categories.

## Abstract

We aimed to identify an acceptable waiting period between the diagnosis of superficial esophageal squamous cell carcinoma (SESCC) and endoscopic submucosal dissection (ESD).

This retrospective, single-center study included 423 patients with 514 SESCC lesions. All patients underwent image-enhanced magnifying endoscopy at initial evaluation and on the day of ESD. Following three outcomes were assessed: the diagnostic accuracy of tumor invasion depth on the day of ESD using the Japanese Esophageal Society classification; changes in diagnosis between initial and final evaluations across different waiting intervals; and 5-year survival rates based on intrapapillary capillary loop patterns (B1 vs. B2) and waiting duration.

The diagnostic accuracy was 96.6% for B1 vessels (EP/LPM), 59.6% for B2 vessels (MM/SM1), and 84.6% for B3 vessels (SM2 or deeper). Among B1 lesions, 100% remained B1 on the day of ESD across all time groups. For B2 lesions, stability was observed in 100% of cases within one month, 98.2% in one to two months, 92.9% in two to three months, and 100% after three months. Five-year survival rates showed no significant differences among waiting period groups in both B1 and B2 categories.

A waiting period of 3 months is acceptable for patients with SESCC classified as B1 vessels, provided the diagnostic accuracy is maintained. Thorough endoscopic evaluation supports safe scheduling flexibility without adversely affecting long-term outcomes.

The online version contains supplementary material available at 10.1007/s10388-025-01156-1.