MetALD Was an Independent Risk Factor for the Recurrence of Early Esophageal Squamous Cell Carcinoma After Endoscopic Resection: A Multicenter Cohort Study Using Directed Acyclic Graphs

MetALD is an independent risk factor for ESCC recurrence after curative ESD, especially among non-abstainers. These findings suggest the synergistic oncogenic potential of moderate alcohol intake and MASLD, and underscore the importance of lifestyle and metabolic interventions in post-ESD management.