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Surgical Endoscopy
Published in: Surgical Endoscopy 5/2021

01-05-2021 | Esophageal Cancer

Short- and long-term outcomes of endoscopic submucosal dissection for superficial esophageal squamous cell cancer in patients with prior gastrectomy

Authors: Jia-Qi Xu, Jian-Wei Hu, Wei-Feng Chen, Mei-Dong Xu, Yun-Shi Zhong, Shi-Yao Chen, Yi-Qun Zhang, Li-Li Ma, Wen-Zheng Qin, Ming-Yan Cai, Li-Qing Yao, Ping-Hong Zhou, Quan-Lin Li

Published in: Surgical Endoscopy | Issue 5/2021

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Abstract

Background

The surgery for esophageal cancer arising after prior gastrectomy is technically difficult with high morbidity and mortality. Endoscopic submucosal dissection (ESD) is a minimally invasive endoscopic treatment for superficial SCC with high curative resection rate. But few studies are concerned about ESD under these circumstances. The aim of this study was to elucidate the short- and long-term outcomes of ESD for superficial esophageal squamous cell cancer (SCC) in patients with prior gastrectomy.

Methods

From January 2009 to January 2019, 37 patients with prior gastrectomy who underwent ESD for superficial esophageal SCC were retrospectively enrolled at the Zhongshan Hospital, Fudan University in Shanghai, China. Rates of en bloc resection, complete resection, curative resection, incidence of postoperative bleeding, perforation and postoperative stricture were evaluated as short-term outcomes. Overall survival, and local recurrence-free survival were evaluated as long-term outcomes.

Results

The rate of en bloc resection, complete resection and curative resection were 94.6%, 86.5% and 78.4%, respectively. No perforation was observed. 1 (2.7%) patient experienced postoperative bleeding. During the median observation of 43 months, 3 (8.6%) patients experienced esophageal stricture, successfully managed by balloon dilation. 3(8.6%) patients had local recurrence after ESD with 5-year local recurrence-free survival rate of 91.4%. During the observation period, 4 patients died of other reasons. The 1, 3, 5-year overall survival rates were 97.1%, 97.1% and 91.4%.

Conclusions

The short-term outcomes indicate ESD is technically difficult with lower resection completeness in patients after gastrectomy, while the long-term outcomes are rather favorable.
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Metadata
Title
Short- and long-term outcomes of endoscopic submucosal dissection for superficial esophageal squamous cell cancer in patients with prior gastrectomy
Authors
Jia-Qi Xu
Jian-Wei Hu
Wei-Feng Chen
Mei-Dong Xu
Yun-Shi Zhong
Shi-Yao Chen
Yi-Qun Zhang
Li-Li Ma
Wen-Zheng Qin
Ming-Yan Cai
Li-Qing Yao
Ping-Hong Zhou
Quan-Lin Li
Publication date
01-05-2021
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 5/2021
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-020-07636-y

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