Diagnostic and treatment strategies for esophageal squamous cell carcinoma from the perspective of kidney deficiency as the root cause and toxicity and stasis as the enabler

Esophageal squamous cell carcinoma (ESCC) is a common malignant tumor with insidious early symptoms and a poor prognosis. In traditional Chinese medicine (TCM), ESCC is classified as "ye ge." Drawing on clinical experience, we believe that kidney deficiency leads to the deficiency of vital qi and immune dysfunction, providing the foundation for cancerous growth by depleting qi and damaging essence, toxic stasis and stagnation, forming a local hypoxic and acidic microenvironment that promotes tumor invasion, metastasis, and recurrence. Considering the effect of modern comprehensive treatments, the occurrence and development of ESCC are summarized as kidney deficiency being the root cause and toxic stasis being the driving force. The pathogenesis and treatment of ESCC in the preoperative, postoperative, and non-surgical treatment stages are discussed. The pathogenesis of the disease is summarized as follows: preoperatively, toxicity and stasis intertwine, depleting the kidney; postoperatively, the kidney loses its vitality, allowing various pathogenic factors to persist; during non-operative treatment, vital qi and pathogens contend, resulting in entrenched toxicity. During the preoperative neoadjuvant phase, therapy should resolve stasis, eliminate toxins, enhance kidney function, tonify essence, and support the body. During the postoperative adjuvant phase, therapy should strengthen the root and consolidate the foundation while detoxifying and expelling stasis. The non-surgical treatment stage uses "balanced interruption," targeting tumor progression and metastasis by harmonizing yin and yang, thus preventing recurrence. This article will provide insights into the integrative Chinese-Western management of ESCC.