Top

Published in:

01-05-2017

A retrospective study of endoscopic resection for 368 patients with early esophageal squamous cell carcinoma or precancerous lesions

Authors: Dongxian Jiang, Xuquan Li, Haixing Wang, Chen Xu, Xiaojing Li, Akesu Sujie, Haiying Zeng, Yingyong Hou, Yunshi Zhong

Published in: Surgical Endoscopy | Issue 5/2017

Abstract

Background

To retrospectively investigate the clinicopathological features and prognosis of early esophageal squamous cell neoplasm (ESCN) treated with endoscopic resection (ER), especially, to compare the prognosis in patients with sm2 cancer and non-sm2 cancer.

Methods

From 2007 to 2013, 368 patients were included in our analysis.

Results

The patients were 252 (68.5 %) men and 116 (31.5 %) women with a median age of 61 (range 16–84 years) years. Hyperplasia, mild dysplasia, moderate dysplasia, severe dysplasia, m1, m2, m3, sm1, and sm2 were diagnosed in 47 (12.8 %), 27 (7.3 %), 34 (9.2 %), 61 (16.6 %), 54 (14.7 %), 38 (10.3 %), 63 (17.1 %), 12 (3.3 %), and 32 (8.7 %) cases. The mean (range) follow-up time was 29 (0–84) months. The cumulative overall 1-, 3-, and 5-year metachronous esophageal lesion rates were 4.1, 12.9, and 32.6 %. The incidence of lymph node or distant metastasis was 1.54 % in m3, 6.25 % in sm2, and 0 in other subgroups. The overall 1-, 3-, and 5-year survival rates were 99.5, 97.3, and 87.5 %. There was significant difference between sm2 and non-sm2 patients in metastatic rate (P = 0.021); however, no difference existed between m3 patients and sm2 patients (P = 0.252). The difference of metachronous esophageal lesion (P = 0.401) and survival (P = 0.634) between sm2 and non-sm2 patients was not obvious.

Conclusions

Our study showed that ER was an effective and relatively safe treatment for superficial ESCN. ER is still appropriate in select sm2 patients. To monitor the second primary cancer in sm2 is necessary during the follow-up.

Rustgi AK, El-Serag HB (2014) Esophageal carcinoma. N Engl J Med 371:2499–2509CrossRefPubMed

Arnold M, Soerjomataram I, Ferlay J, Forman D (2015) Global incidence of oesophageal cancer by histological subtype in 2012. Gut 64:381–387CrossRefPubMed

Mocanu A, Barla R, Hoara P, Constantinoiu S (2015) Current endoscopic methods of radical therapy in early esophageal cancer. J Med Life 8:150–156PubMedPubMedCentral

Crumley AB, Going JJ, McEwan K, McKernan M, Abela JE, Shearer CJ, Stuart RC (2011) Endoscopic mucosal resection for gastroesophageal cancer in a U.K. population: long-term follow-up of a consecutive series. Surg Endosc 25:543–548CrossRefPubMed

Higuchi K, Tanabe S, Azuma M, Katada C, Sasaki T, Ishido K, Naruke A, Katada N, Koizumi W (2013) A phase II study of endoscopic submucosal dissection for superficial esophageal neoplasms (KDOG 0901). Gastrointest Endosc 78:704–710CrossRefPubMed

Yamada M, Oda I, Nonaka S, Suzuki H, Yoshinaga S, Taniguchi H, Sekine S, Kushima R, Saito Y, Gotoda T (2013) Long-term outcome of endoscopic resection of superficial adenocarcinoma of the esophagogastric junction. Endoscopy 45:992–996CrossRefPubMed

Yamashina T, Ishihara R, Nagai K, Matsuura N, Matsui F, Ito T, Fujii M, Yamamoto S, Hanaoka N, Takeuchi Y, Higashino K, Uedo N, Iishi H (2013) Long-term outcome and metastatic risk after endoscopic resection of superficial esophageal squamous cell carcinoma. Am J Gastroenterol 108:544–551CrossRefPubMed

Tsujii Y, Nishida T, Nishiyama O, Yamamoto K, Kawai N, Yamaguchi S, Yamada T, Yoshio T, Kitamura S, Nakamura T, Nishihara A, Ogiyama H, Nakahara M, Komori M, Kato M, Hayashi Y, Shinzaki S, Iijima H, Michida T, Tsujii M, Takehara T (2015) Clinical outcomes of endoscopic submucosal dissection for superficial esophageal neoplasms: a multicenter retrospective cohort study. Endoscopy 47:775–783CrossRefPubMed

Ono S, Fujishiro M, Niimi K, Goto O, Kodashima S, Yamamichi N, Omata M (2009) Long-term outcomes of endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms. Gastrointest Endosc 70:860–866CrossRefPubMed

10.

Schlemper RJ, Dawsey SM, Itabashi M, Iwashita A, Kato Y, Koike M, Lewin KJ, Riddell RH, Shimoda T, Sipponen P, Stolte M, Watanabe H (2000) Differences in diagnostic criteria for esophageal squamous cell carcinoma between Japanese and Western pathologists. Cancer 88:996–1006CrossRefPubMed

11.

Vieth M, Stolte M (2005) Pathology of early upper GI cancers. Best Pract Res Clin Gastroenterol 19:857–869CrossRefPubMed

12.

Shi Q, Ju H, Yao LQ, Zhou PH, Xu MD, Chen T, Zhou JM, Chen TY, Zhong YS (2014) Risk factors for postoperative stricture after endoscopic submucosal dissection for superficial esophageal carcinoma. Endoscopy 46:640–644CrossRefPubMed

13.

Akutsu Y, Uesato M, Shuto K, Kono T, Hoshino I, Horibe D, Sazuka T, Takeshita N, Maruyama T, Isozaki Y, Akanuma N, Matsubara H (2013) The overall prevalence of metastasis in T1 esophageal squamous cell carcinoma: a retrospective analysis of 295 patients. Ann Surg 257:1032–1038CrossRefPubMed

14.

Shimoda T (2011) Japanese classification of esophageal cancer, the 10th edition: pathological part. Nihon Rinsho 69(Suppl 6):109–120PubMed

15.

Wani S, Drahos J, Cook MB, Rastogi A, Bansal A, Yen R, Sharma P, Das A (2014) Comparison of endoscopic therapies and surgical resection in patients with early esophageal cancer: a population-based study. Gastrointest Endosc 79(224–232):e1

16.

Chung SC, Stuart RC, Li AK (1994) Surgical therapy for squamous-cell carcinoma of the oesophagus. Lancet 343:521–524CrossRefPubMed

17.

Merkow RP, Bilimoria KY, Keswani RN, Chung J, Sherman KL, Knab LM, Posner MC, Bentrem DJ (2014) Treatment trends, risk of lymph node metastasis, and outcomes for localized esophageal cancer. J Natl Cancer Inst 16:106–107

18.

Takubo K, Makuuchi H, Fujita H, Isono K (2009) Japanese classification of esophageal cancer, tenth edition: part I. ESOPHAGUS 6:1–25CrossRef

19.

Li ZS, Li Q (2011) The latest 2010 WHO classification of tumors of digestive system. Zhonghua Bing Li Xue Za Zhi 40:351–354PubMed

20.

Ueno H, Mochizuki H, Hashiguchi Y, Shimazaki H, Aida S, Hase K, Matsukuma S, Kanai T, Kurihara H, Ozawa K, Yoshimura K, Bekku S (2004) Risk factors for an adverse outcome in early invasive colorectal carcinoma. Gastroenterology 127:385–394CrossRefPubMed

21.

Deyhle P, Jenny S, Fumagalli I (1973) Endoscopic polypectomy in the proximal colon: a diagnostic, therapeutic (and preventive?) intervention]. Dtsch Med Wochenschr 98:219–220CrossRefPubMed

22.

Takekoshi T, Baba Y, Ota H, Kato Y, Yanagisawa A, Takagi K, Noguchi Y (1994) Endoscopic resection of early gastric carcinoma: results of a retrospective analysis of 308 cases. Endoscopy 26:352–358CrossRefPubMed

23.

Oyama T, Tomori A, Hotta K, Morita S, Kominato K, Tanaka M, Miyata Y (2005) Endoscopic submucosal dissection of early esophageal cancer. Clin Gastroenterol Hepatol 3:S67–S70CrossRefPubMed

24.

Yano T, Ono H, Doi T, Hasegawa H, Honda M, Oono Y, Ikematsu H, Tanaka M, Kakushima N, Kaneko K, Sato A, Ohtsu A (2014) Endoscopic submucosal dissection using a new scissors-type electrosurgical knife: a first-in-human feasibility study. Endoscopy 46:754–757CrossRefPubMed

25.

Kato M, Nakajima K, Yamada T, Hirota M, Miyazaki Y, Yamasaki M, Nishida T, Mori M, Doki Y, Tsujii M, Takehara T (2014) Esophageal submucosal dissection under steady pressure automatically controlled endoscopy (SPACE): a clinical feasibility study. Endoscopy 46:680–684CrossRefPubMed

26.

Bhatt A, Abe S, Kumaravel A, Vargo J, Saito Y (2015) Indications and techniques for endoscopic submucosal dissection. Am J Gastroenterol 110:784–791CrossRefPubMed

27.

Zhai Y, Linghu E, Li H (2014) Double-tunnel endoscopic submucosal tunnel dissection for circumferential superficial esophageal neoplasms. Endoscopy 46(Suppl 1):E204–E205PubMed

28.

Probst A, Aust D, Markl B, Anthuber M, Messmann H (2015) Early esophageal cancer in Europe: endoscopic treatment by endoscopic submucosal dissection. Endoscopy 47:113–121PubMed

29.

Joo DC, Kim GH, Park DY, Jhi JH, Song GA (2014) Long-term outcome after endoscopic submucosal dissection in patients with superficial esophageal squamous cell carcinoma: a single-center study. Gut Liver 8:612–618CrossRefPubMedPubMedCentral

30.

Pech O, May A, Manner H, Behrens A, Pohl J, Weferling M, Hartmann U, Manner N, Huijsmans J, Gossner L, Rabenstein T, Vieth M, Stolte M, Ell C (2014) Long-term efficacy and safety of endoscopic resection for patients with mucosal adenocarcinoma of the esophagus. Gastroenterology 146(652–660):e1

31.

Kuwano H, Nishimura Y, Oyama T, Kato H, Kitagawa Y, Kusano M, Shimada H, Takiuchi H, Toh Y, Doki Y, Naomoto Y, Matsubara H, Miyazaki T, Muto M, Yanagisawa A (2015) Guidelines for diagnosis and treatment of carcinoma of the esophagus April 2012 edited by the Japan Esophageal Society. Esophagus 12:1–30CrossRefPubMed

32.

Badreddine RJ, Prasad GA, Lewis JT, Lutzke LS, Borkenhagen LS, Dunagan KT, Wang KK (2010) Depth of submucosal invasion does not predict lymph node metastasis and survival of patients with esophageal carcinoma. Clin Gastroenterol Hepatol 8:248–253CrossRefPubMed

33.

Manner H, May A, Pech O, Gossner L, Rabenstein T, Günter E, Vieth M, Stolte M, Ell C (2008) Early Barrett’s carcinoma with “low-risk” submucosal invasion: long-term results of endoscopic resection with a curative intent. Am J Gastroenterol 103:2589–2597CrossRefPubMed

34.

Higuchi K, Tanabe S, Koizumi W, Sasaki T, Nakatani K, Saigenji K, Kobayashi N, Mitomi H (2007) Expansion of the indications for endoscopic mucosal resection in patients with superficial esophageal carcinoma. Endoscopy 39:36–40CrossRefPubMed

35.

Diseases TJSF (2002) Comprehensive registry of esophageal cancer in Japan, 3rd edn. The Japanese Society for Esophageal Diseases, Chiba

Title: A retrospective study of endoscopic resection for 368 patients with early esophageal squamous cell carcinoma or precancerous lesions
Authors: Dongxian Jiang
Xuquan Li
Haixing Wang
Chen Xu
Xiaojing Li
Akesu Sujie
Haiying Zeng
Yingyong Hou
Yunshi Zhong
Publication date: 01-05-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 5/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-016-5208-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A retrospective study of endoscopic resection for 368 patients with early esophageal squamous cell carcinoma or precancerous lesions

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2017

Technical feasibility and safety of laparoscopic right hepatectomy for hepatocellular carcinoma following sequential TACE–PVE: a comparative study

SAGES clinical spotlight review: intraoperative cholangiography

The effect of a performance-based intra-procedural checklist on a simulated emergency laparoscopic task in novice surgeons

A research agenda for the European Association for Endoscopic Surgeons (EAES)

Accuracy of preoperative tumor localization in large bowel using 3D magnetic endoscopic imaging: randomized clinical trial

Laparoscopic versus open pancreaticoduodenectomy for pancreatic adenocarcinoma: long-term results at a single institution