Applications of circulating tumor cells in esophageal cancer detection and treatment

Esophageal cancer (EC) is highly invasive, recurrent, and metastatic, with high incidence and mortality rates, particularly in China, where it remains endemic. Although metastasis has traditionally been considered a late event in tumor progression, increasing experimental and clinical evidence suggests that dissemination of tumor cells may occur at earlier disease stages than previously recognized [1]. Detection of circulating tumor cells (CTCs) in the bloodstream may indicate tumor dissemination, making CTCs a key factor in the metastatic cascade. In recent years, despite progress in CTC research, there is still a lack of systematic and significant evidence to confirm the diagnostic, monitoring, and prognostic value of CTCs in EC. This review aims to summarize current evidence on the relationship between CTCs and EC and to provide insights that may support improved management and treatment strategies for EC.