Western outcomes of circumferential endoscopic submucosal dissection for early esophageal squamous cell carcinoma.

BACKGROUND AND AIMS: Circumferential endoscopic submucosal dissection (cESD) in the esophagus has been reported to be feasible in small Eastern case series. We assessed the outcomes of cESD in the treatment of early esophageal squamous cell carcinoma (ESCC) in Western countries. METHODS: We conducted an international study at 25 referral centers in Europe and Australia using prospective databases. We included all patients with ESCC treated with cESD before November 2022. Our main outcomes were curative resection according to European guidelines and adverse events. RESULTS: A total of 171 cESDs were performed on 165 patients. En bloc and R0 resections rates were 98.2% (95% confidence interval [CI], 95.0-99.4) and 69.6% (95% CI, 62.3-76.0), respectively. Curative resection was achieved in 49.1% (95% CI, 41.7-56.6) of the lesions. The most common reason for noncurative resection was deep submucosal invasion (21.6%). The risk of stricture requiring 6 or more dilations or additional techniques (incisional therapy/stent) was high (71%), despite the use of prophylactic measures in 93% of the procedures. The rates of intraprocedural perforation, delayed bleeding, and adverse cardiorespiratory events were 4.1%, 0.6%, and 4.7%, respectively. Two patients died (1.2%) of a cESD-related adverse event. Overall and disease-free survival rates at 2 years were 91% and 79%. CONCLUSIONS: In Western referral centers, cESD for ESCC is curative in approximately half of the lesions. It can be considered a feasible treatment in selected patients. Our results suggest the need to improve patient selection and to develop more effective therapies to prevent esophageal strictures.

Validation of an Emotion Regulation Training Program on Mental Well-Being.

This research aimed to validate an Emotion Regulation Training program cultivating resilience, strengthening interpersonal communication, and enhancing emotional intelligence. A community sample of 104 participants were assigned to either an intervention (n = 51) or nonactive control (n = 53) group matched by age and gender. In addition, data were gathered via a cognitive performance test conducted pre- and postmeasurement in a subset of the larger sample (n = 19 intervention, n = 19 control). Results revealed reappraisal significantly increased in the intervention group, which was associated with a decrease in depressive symptomology, worry, and suppression, and a concurrent increase in overall mental well-being, supporting the validation of the Emotion Regulation Training program.

Effect of an Emotion Regulation Training Program on Mental Well-Being.

This study aimed to develop and validate a brief emotion regulation training program that improved mental well-being. The program was preventative in nature, designed to build resilience while fostering more satisfying personal and professional relationships in a community sample. It was developed and piloted with 10 graduate students during Study 1; for Study 2, a community sample of 75 adults were randomly allocated to either a treatment (n = 38) or control (n = 37) group. In the pilot program, the social validity of the program was confirmed, while study 2 demonstrated significant changes in positive coping techniques (i.e., reappraisal) at one-year follow-up in the treatment group when compared with the control. These findings may have broad implications in the health sector due to the brevity, scalability, and cost-effectiveness of this newly designed intervention.