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The Efficacy of Combined EMR， ESD， and RFA in the Treatment of Multifocal Esophageal Precancerous Lesions
Received date: 2025-03-18
Revised date: 2025-08-28
Accepted date: 2025-12-24
Online published: 2025-12-24
Esophageal cancer， as a highly lethal malignant tumor worldwide， is significantly associated with adverse lifestyle factors such as tobacco smoking， excessive alcohol consumption， and long-term intake of overheated or preserved foods. In clinical practice， the standardized treatment of multifocal esophageal precancerous lesions remains a major challenge， as current single therapeutic modalities often show limited efficacy in managing complex lesions. In recent years， the combined application of endoscopic mucosal resection （EMR）， endoscopic submucosal dissection （ESD）， and radiofrequency ablation （RFA） has drawn increasing attention. This article aims to systematically review the research progress over the past decade from both domestic and international studies， focusing on the indications， technical characteristics， therapeutic efficacy， and safety management of EMR/ESD combined with RFA in the treatment of multifocal esophageal precancerous lesions. Current evidence suggests that this combined strategy significantly enhances the complete eradication rate of lesions， reduces the incidence of postoperative stricture and recurrence， and demonstrates a lower overall complication rate compared to monotherapies. The sequential and individualized approach offers high adaptability and repeatability， particularly in patients with multifocal or high-risk lesions. Although current follow-up data indicate a median recurrence-free survival （RFS） of up to 34 months， long-term survival outcomes and recurrence risk remain insufficiently studied. Future research should focus on multicenter， large-sample， long-term follow-up studies to further validate its effectiveness and facilitate the development of standardized therapeutic protocols， ultimately improving clinical decision-making and patient outcomes.
梦琪 戚
.
The Efficacy of Combined EMR， ESD， and RFA in the Treatment of Multifocal
Esophageal Precancerous Lesions
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