# Oesophageal squamous cell carcinoma

Source: https://onco.cc/cancers/oesophageal-squamous-cell-carcinoma/  
OnCo record `oesophageal-squamous-cell-carcinoma` (Cancer). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Squamous cell carcinoma of the oesophagus, the world's commonest form, is linked to smoking, alcohol and very hot drinks and sits in the upper and middle gullet. It is treated with chemoradiation, with or without surgery, and immunotherapy has recently joined chemotherapy for advanced disease.

## Summary

Oesophageal squamous cell carcinoma arises from the squamous lining of the upper and middle oesophagus; tobacco, alcohol, scalding drinks, nutritional deficiency and achalasia are its causes, and TP53 and NOTCH1 mutations its genetics. Early lesions found by endoscopy, common in Japanese and Chinese screening programmes, are removed endoscopically. Locally advanced disease is treated either with neoadjuvant chemoradiation followed by surgery (CROSS) or with definitive chemoradiation alone, which cures a similar share in this histology; adjuvant nivolumab after chemoradiation and surgery lowers recurrence when residual disease remains (CheckMate 577). Advanced disease is treated with nivolumab plus chemotherapy or nivolumab plus ipilimumab (CheckMate 648) or pembrolizumab plus chemotherapy (KEYNOTE-590); Chinese trials with camrelizumab, tislelizumab, toripalimab and sintilimab have produced the same result.

## Fields

- Kind: Cancer
- Last checked: 2026-09-17
- Also known as: Esophageal squamous cell carcinoma; ESCC; Oesophageal SCC
- Tags: subtype-page
- Group: gastrointestinal
- Burden: About 85 percent of oesophageal cancers worldwide and the dominant type across the Asian oesophageal cancer belt, East Africa and South America; in high-income countries it is now outnumbered by adenocarcinoma, and five-year survival is around 20 percent overall.
- Subtypes: Upper and middle third squamous cell carcinoma; Early (T1a) squamous cell carcinoma (endoscopic resection); Locally advanced (chemoradiation with or without surgery); Metastatic (immunotherapy plus chemotherapy)
- Biomarkers: PD-L1 combined positive score or tumour proportion score; TP53 and NOTCH1 mutations; Endoscopic Lugol staining for early lesions; Pathological response after chemoradiation

## Sections of this record

The page is a hub with ten sections in reading order; large sections have their own page. The same plan as JSON: https://onco.cc/api/v1/cancers/oesophageal-squamous-cell-carcinoma/sections.json

- Overview (on the hub): The TL;DR, the family this cancer belongs to, the organ, who gets it and what the state of the art is. https://onco.cc/cancers/oesophageal-squamous-cell-carcinoma/#overview [3 state-of-the-art points]
- Types and stages (on the hub): Anatomy, the subtypes and how they differ, how it is staged, and where advanced disease spreads. https://onco.cc/cancers/oesophageal-squamous-cell-carcinoma/#what-it-is [4 subtypes]
- Symptoms and diagnosis (on the hub): How this cancer shows itself, how the diagnosis is confirmed, and the biomarkers clinicians test for. https://onco.cc/cancers/oesophageal-squamous-cell-carcinoma/#finding-it [4 biomarkers]
- Treatment (on the hub): The standard of care by setting, the medicines, surgery and radiotherapy named in it, and the regimens behind them. https://onco.cc/cancers/oesophageal-squamous-cell-carcinoma/#treating-it [4 settings, 3 decisions with options]
- Trials and papers (on the hub): Trials recruiting now, the landmark trials, the trials held by this cancer's subtypes, the key papers and what they mean, the latest literature, and the milestones year by year. https://onco.cc/cancers/oesophageal-squamous-cell-carcinoma/#evidence [17 trials, 4 key papers, 4 milestones]
- Biology and targets (on the hub): The molecular landscape: the targets and how often each appears, the pathways, the mechanics stages and the preclinical models. https://onco.cc/cancers/oesophageal-squamous-cell-carcinoma/#science [7 targets]
- Countries and centres (own page): Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes. https://onco.cc/cancers/oesophageal-squamous-cell-carcinoma/where-you-are/ [1 centre]
- Decisions and support (on the hub): The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask. https://onco.cc/cancers/oesophageal-squamous-cell-carcinoma/#living-with-it [17 questions, 6 red cards]
- Pipeline and open problems (own page): Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record. https://onco.cc/cancers/oesophageal-squamous-cell-carcinoma/coming/ [8 medicines, 17 trials, 3 open problems]
- Data (own page): Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked. https://onco.cc/cancers/oesophageal-squamous-cell-carcinoma/data/ [51 connected records]

## Standard of care

- Early (T1a): Endoscopic submucosal dissection; oesophagectomy or chemoradiation if deeper invasion is found. ([Endoscopic resection (EMR / ESD)](https://onco.cc/technologies/endoscopic-resection/))
- Locally advanced: Neoadjuvant carboplatin-paclitaxel chemoradiation and surgery (CROSS), or definitive cisplatin-fluorouracil chemoradiation with surgery reserved for persistent disease; adjuvant nivolumab after incomplete response (CheckMate 577). ([CROSS](https://onco.cc/trials/cross/), [Carboplatin](https://onco.cc/drugs/carboplatin/), [Paclitaxel / nab-paclitaxel](https://onco.cc/drugs/paclitaxel/), [Cisplatin](https://onco.cc/drugs/cisplatin/), [Fluorouracil (5-FU)](https://onco.cc/drugs/fluorouracil/), [Nivolumab](https://onco.cc/drugs/nivolumab/), [CheckMate 577](https://onco.cc/trials/checkmate-577/))
- Metastatic, first line: Nivolumab plus chemotherapy or nivolumab plus ipilimumab (CheckMate 648), or pembrolizumab plus chemotherapy (KEYNOTE-590). ([Nivolumab](https://onco.cc/drugs/nivolumab/), [Ipilimumab](https://onco.cc/drugs/ipilimumab/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/), [CheckMate 648](https://onco.cc/trials/checkmate-648/), [KEYNOTE-590](https://onco.cc/trials/keynote-590/))
- Prevention and screening: Smoking cessation, alcohol reduction, avoiding very hot drinks; endoscopic screening in high-incidence regions of China. ([Smoking cessation in cancer patients](https://onco.cc/technologies/smoking-cessation-after-diagnosis/), [Alcohol reduction, pricing and cancer warning labels](https://onco.cc/technologies/alcohol-reduction-labelling/))

## State of the art

- Immunotherapy added to chemotherapy improved survival in every first-line trial, including several run entirely in China.
- Organ preservation with definitive chemoradiation and surveillance is an accepted alternative to surgery in this histology.
- Endoscopic screening in China detects a large share of cancers at a curable stage.

## Open problems

- Whether surgery can be omitted after a complete response to chemoradiation.
- Most cases worldwide present late without access to endoscopy.
- Nutrition, swallowing and quality of life during and after treatment.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Esophageal_cancer
- Wikipedia: https://en.wikipedia.org/wiki/Esophageal_cancer

## Connected records

- cancers: [Oesophageal and junctional adenocarcinoma](https://onco.cc/cancers/oesophageal-adenocarcinoma/), [Oesophageal cancer](https://onco.cc/cancers/esophageal/)
- key papers: [CheckMate 577: adjuvant nivolumab in resected oesophageal or gastro-oesophageal junction cancer](https://onco.cc/key-papers/paper-checkmate-577-nejm-2021/), [CheckMate 648: nivolumab combination therapy in advanced oesophageal squamous cell carcinoma](https://onco.cc/key-papers/paper-checkmate-648-nejm-2022/), [CROSS: preoperative chemoradiotherapy for oesophageal or junctional cancer](https://onco.cc/key-papers/paper-cross-nejm-2012/), [KEYNOTE-590: pembrolizumab plus chemotherapy for first-line treatment of advanced oesophageal cancer](https://onco.cc/key-papers/paper-keynote-590-lancet-2021/)
- trials: [A Phase II Clinical Study to Evaluate HLX43 in Patients With Recurrent/Metastatic ESCC Failed or Intolerance to Standard Therapy](https://onco.cc/trials/nct06769113/), [A Study of BL-B01D1 in Combination With Tislelizumab ±5-Fluorouracil Versus Platinum-Based Chemotherapy Plus Tislelizumab as First-line Treatment in Patients With Unresectable, Locally Advanced Recurrent or Metastatic Esophageal Squamous Cell Carcinoma(PANKU-Esophagus02)](https://onco.cc/trials/nct07554456/), [A Study of Ifinatamab Deruxtecan in Subjects With Pretreated Advanced or Metastatic Esophageal Squamous Cell Carcinoma (ESCC) (IDeate-Esophageal01)](https://onco.cc/trials/nct06644781/), [A Study of KC1036 Versus Investigator's Choice of Chemotherapy in Patients With Advanced Esophageal Cancer](https://onco.cc/trials/nct06194734/), [A Study to Compare the Efficacy and Safety of LY01015 and Opdivo® Combined Respectively With Chemotherapy in Advanced or Metastatic Esophageal Squamous Cell Carcinoma](https://onco.cc/trials/nct06022861/), [CheckMate 577](https://onco.cc/trials/checkmate-577/), [CheckMate 648](https://onco.cc/trials/checkmate-648/), [Clinical Study of Time Optimizing of Endoscopic Photodynamic Therapy on Esophageal and/or Gastric Cardiac Cancer](https://onco.cc/trials/nct02628665/), [Concurrent Chemoradiotherapy After Endoscopic Resection for Stage I Esophageal Carcinoma](https://onco.cc/trials/nct04275986/), [CROSS](https://onco.cc/trials/cross/), [KC1036 in Combination With PD-1 Antibody and Platinum-based Chemotherapy for First-line Advanced Esophageal Cancer](https://onco.cc/trials/nct07481058/), [KEYNOTE-590](https://onco.cc/trials/keynote-590/), [QLC5508 vs. Chemotherapy in Pretreated Advanced or Metastatic Esophageal Squamous Cell Carcinoma](https://onco.cc/trials/nct07463573/), [SKB500 Combinations in Patients With Esophageal Squamous Cell Carcinoma](https://onco.cc/trials/nct07700667/), [Study of Adebrelimab With Chemotherapy, Endoscopy and Sequential Chemoradiotherapy In Inoperable Esophageal Cancer](https://onco.cc/trials/nct06599775/), [Study of Durvalumab Versus Placebo in Combination With Definitive Chemoradiation Therapy in Patient With ESCC](https://onco.cc/trials/nct04550260/), [Study of Larotinib in Unresectable Advanced or Recurrent Esophageal Cancer](https://onco.cc/trials/nct04415853/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/), [Cisplatin](https://onco.cc/drugs/cisplatin/), [Fluorouracil (5-FU)](https://onco.cc/drugs/fluorouracil/), [Ipilimumab](https://onco.cc/drugs/ipilimumab/), [Nivolumab](https://onco.cc/drugs/nivolumab/), [Paclitaxel / nab-paclitaxel](https://onco.cc/drugs/paclitaxel/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/), [Tislelizumab](https://onco.cc/drugs/tislelizumab/)
- technologies: [Alcohol reduction, pricing and cancer warning labels](https://onco.cc/technologies/alcohol-reduction-labelling/), [Endoscopic resection (EMR / ESD)](https://onco.cc/technologies/endoscopic-resection/), [Smoking cessation in cancer patients](https://onco.cc/technologies/smoking-cessation-after-diagnosis/)
- people: [Jong-Mu Sun](https://onco.cc/people/jong-mu-sun/), [Yuichiro Doki](https://onco.cc/people/yuichiro-doki/)
- institutions: [Osaka University Graduate School of Medicine / Osaka University Hospital](https://onco.cc/institutions/osaka-university/)
- biomarkers: [PD-L1 CPS (combined positive score)](https://onco.cc/biomarkers/pd-l1-cps/)
- targets: [CLIP1](https://onco.cc/targets/clip1/), [MSN](https://onco.cc/targets/msn/), [RAP1GDS1](https://onco.cc/targets/rap1gds1/), [TEC](https://onco.cc/targets/tec/), [ZBTB16](https://onco.cc/targets/zbtb16/)

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JSON: https://onco.cc/api/v1/entities/oesophageal-squamous-cell-carcinoma.json