Sato D, Kadota T, Inaba A, et al. - Endoscopic resection (ER) offered a favorable long-term outcome in cases with esophageal squamous cell carcinoma (ESCC) invading the muscularis mucosae (pMM) without lymphovascular invasion (LVI); however these patients carried a risk of recurrence directly resulting in death. Need for long-term follow-up, with attention to the timing of recurrence, is highlighted.

• A retrospective analysis of 87 followed-up patients who had ER and were pathologically diagnosed with pMM ESCC without LVI without additional treatments.

• A median follow-up of 64 months revealed development of lymph node and/or distant recurrence in 3 patients, and 2 of these cases occurred more than 3 years post-ER; primary disease caused deaths of all 3 patients.

• The 5-year cumulative recurrence rate and the 5-year recurrence-free, disease-specific, and overall survival rates were 4.3%, 88.8%, 98.2%, and 91.7%, respectively.