Photodynamic Therapy as a Promising Treatment for Long-segment and Whole-circumferential Early Esophageal Cancer

Photodynamic therapy (PDT) is an effective endoscopic therapy indicated for early esophageal cancer, but there have been few reports of PDT for circumferential lesions so far. To investigate the clinical outcome of PDT for patients with whole-circumferential early esophageal squamous cell carcinoma (ESCC). Patients with whole-circumferential early ESCC, who received PDT between January 2020 and July 2022 were retrospectively evaluated. An analysis for comparisons between the results of PDT and contemporaneous endoscopic submucosal dissection (ESD) for similar esophageal lesions was conducted. The complete response (CR) rate was 83.33% after PDT treatment for a median tumor length of 9.5cm. A longer tumor length (>10cm) was the risk factor of PDT failure (P=0.045). Post-PDT strictures are easier to resolve than ESD, yielding a shorter dysphagia duration. PDT can be expected to be an effective and safe endoscopic modality for long-segment and whole-circumferential early ESCC.