Management decision based on lymphovascular involvement leads to favorable outcomes after endoscopic treatment of esophageal squamous cell carcinoma.
Endoscopy
; 50(7): 662-670, 2018 07.
Article
em En
| MEDLINE
| ID: mdl-29272907
ABSTRACT
BACKGROUND:
Esophageal squamous cell carcinoma (ESCC) invading the muscularis mucosae (MM) and submucosa up to 200âµm (SM1) has a risk of metastasis. The aims of this study were to investigate the long-term outcome of endoscopic submucosal dissection (ESD) for MM/SM1 ESCC and to assess the management after ESD in our hospital.METHODS:
This was a retrospective cohort study conducted at a single institution. Patients with MM or SM1 ESCC who were treated with ESD were included. Additional prophylactic therapy was added if lymphovascular involvement (LVI) was noted in the ESD specimens.RESULTS:
A total of 102 patients were analyzed. The median length of follow-up was 71.5 months (range 9â-â144 months) and the median number of CTs was 6 (range 0â-â24). LVI was found in 21 patients (20.6â%), and 12 patients underwent additional prophylactic therapy. The 5-year overall survival, disease-specific survival, and tumor-free survival rates were 84.1â%, 97.5â%, and 82.1â%, respectively. A total of 26 patients died, but only 2 of them died from ESCC. The cumulative metastasis rate was 11.8â%, and LVI was a significant predictor of metastasis (hazard ratio 5.42, 95â% confidence interval 1.39â-â21.18; Pâ=â0.02). There were no differences between patients with MM ESCC and those with SM1 ESCC.CONCLUSIONS:
The long-term outcome after ESD for MM/SM1 ESCC was favorable with additional prophylactic therapy and strict adherence to follow-up.âThese results indicate that our management decision based on LVI is a valid approach and that ESD can be offered as a therapeutic option to MM/SM1 ESCCs.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Tipos_de_cancer
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Esofago
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Esofágicas
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Ressecção Endoscópica de Mucosa
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Carcinoma de Células Escamosas do Esôfago
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Japão