Advanced feasibility of endoscopic submucosal dissection for the treatment of gastric tube cancer after esophagectomy

Tawaraya, Shin; Jin, Mario; Matsuhashi, Tamotsu; Suzuki, Yusato; Sawaguchi, Masayuki; Watanabe, Noboru; Onochi, Kengo; Koizumi, Shigeto; Hatakeyama, Natsumi; Ohba, Reina; Mashima, Hirosato; Ohnishi, Hirohide

doi:10.1016/j.gie.2013.10.007

Cited by 14 publications

(16 citation statements)

References 13 publications

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“…Due to recent advances in the diagnosis and treatment of esophageal cancer, surgical outcomes have improved and the prevalence of GTC after esophagectomy has increased to 2.1%-3.5%[ 2 , 13 ]. The characteristics and treatments of 224 GTC patients reported in 29 studies (12 retrospective studies and 17 case reports) between 1998 and 2020 (Table 1 )[ 3 - 6 , 12 , 14 - 37 ] showed that the mean age of patients at the time of GTC treatment was 67.2 years (range: 43-85 years), and 202 patients (90.2%) were male. According to the available data of these studies, the majority of GTCs were the differentiated type (77.3%; n = 160), followed by the undifferentiated type (19.8%; n = 41), and others (mixed type, neuroendocrine carcinoma, squamous cell carcinoma; n = 7).…”

Section: Discussionmentioning

confidence: 99%

Distal gastric tube resection with vascular preservation for gastric tube cancer: A case report and review of literature

Yura

Koyanagi

Adachi

et al. 2020

WJGS

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BACKGROUND Survival rates in patients with esophageal cancer undergoing esophagectomy have improved, but the prevalence of gastric tube cancer (GTC) has also increased. Total resection of the gastric tube with lymph node dissection is considered a radical treatment, but GTC surgery is more invasive and involves a higher risk of severe complications or death, particularly in elderly patients. CASE SUMMARY We report an elderly patient with early GTC that had invaded the duodenum who was successfully treated with resection of the distal gastric tube and Roux-en-Y (R-Y) reconstruction. The tumor was a type 0-IIc lesion with ulcer scars surrounding the pyloric ring. Endoscopic submucosal resection was not indicated because the primary lesion was submucosally invasive, was undifferentiated type, surrounded the pyloric ring, and had invaded the duodenum. Resection of distal gastric tube with R-Y reconstruction was safely performed, with preservation of the right gastroepiploic artery (RGEA) and right gastric artery (RGA). CONCLUSION Distal resection of the gastric tube with preservation of the RGEA and RGA is a good treatment option for elderly patients with cT1bN0 GTC in the lower part of the gastric tube.

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Section: Discussionmentioning

confidence: 99%

Distal gastric tube resection with vascular preservation for gastric tube cancer: A case report and review of literature

Yura

Koyanagi

Adachi

et al. 2020

WJGS

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“…Although ESD for GTC is safe and effective [8] [11], it is more di cult to resect lesions than early gastric cancer without reconstruction. The gastric tube has limited working space, food retention, and uid pooling due to notable deformity of the stomach and severe brosis on the suture line after surgical reconstruction [12]. Therefore, ESD for GTC should be performed by fully trained endoscopists.…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic submucosal dissection (ESD) was developed as a minimally invasive treatment for early gastrointestinal carcinoma [6] [7], and it has been attempted for GTC, as well [8] [9] [10] [11]. However, the technical di culty of the procedure increases greatly with brotic changes of the suture line due to surgical reconstruction [12] (Fig. 1), limited working space, and worsened maneuverability of the endoscope.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Submucosal Dissection for Gastric Tube Carcinoma After Esophagectomy Contributes to Long-Term Outcomes: A Retrospective Case Series

Hashimoto

Sato

Mizuno

et al. 2020

Preprint

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Background: Gastric tube carcinoma (GTC) after esophagectomy has been observed increasingly in recent years after advanced treatment of esophageal carcinoma. Surgical removal of the reconstructed gastric tube is not usually preferred; however, endoscopic submucosal dissection (ESD) is greatly anticipated to be a promising option. This study investigated the efficacy and safety of ESD for GTC. Methods: This study was designed based on a retrospective survey performed at our single center between 2003 and 2018. Patients with GTC were treated with ESD and followed-up according to the policy of our institution. The curability of ESD was evaluated histologically according to the Japanese gastric cancer treatment guidelines. Patient characteristics, outcomes of ESD procedures, and long-term outcomes were analyzed. Results: A total of 31 patients (2 females; median age, 73 years) with 45 GTC cases were treated with ESD. The mean period from esophagectomy to the diagnosis of GTC was 10.6 years. The only adverse event due to ESD was bleeding (2 patients: 4.4%). No fatal events, such as perforation, occurred. The rates of complete resections and curative resections were 86.7% and 60.0%, respectively. The 3-year and 5-year overall survival rates were 67.6% and 47.7%, respectively. The 3-year and 5-year disease-specific survival rates were 100% and 92.9%, respectively. One patient died of GTC and 14 patients died of other diseases, including five primary carcinomas. Conclusions: ESD for GTC can be a safe treatment and contribute to positive long-term outcomes. Long-term regular gastroscopy is required for early detection. Screening should be performed before ESD and follow-up should be performed after ESD to prolong overall survival.

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“…Although ESD for GTC is safe and effective [6] [8], it is more di cult to resect lesions than early gastric cancer without reconstruction. The gastric tube has limited working space and can cause food retention and uid pooling due to a notable deformity of the stomach and severe brosis on the suture line after surgical reconstruction [9]. Therefore, ESD for GTC should be performed by fully trained endoscopists.…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic submucosal dissection (ESD) was developed as a minimally invasive treatment for early gastrointestinal carcinoma [5], and it has been attempted for GTC as well [6] [7] [8]. However, the technical di culty of the procedure increases greatly with brotic changes of the suture line due to surgical reconstruction [9] (Fig. 1), limited working space, and worsened maneuverability of the endoscope.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic submucosal dissection for gastric tube carcinoma after esophagectomy contributes to long-term outcomes: a retrospective case series

Hashimoto

Sato

Mizuno

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Gastric tube carcinoma (GTC) after esophagectomy has been observed increasingly in recent years after advanced treatment of esophageal carcinoma. Surgical removal of the reconstructed gastric tube is not usually preferred; however, endoscopic submucosal dissection (ESD) is greatly anticipated to be a promising option. This study investigated the efficacy and safety of ESD for GTC. Methods: This study was designed based on a retrospective survey performed at our single center between 2003 and 2018. Patients with GTC were treated with ESD and followed-up according to the policy of our institution. The curability of ESD was evaluated histologically according to the Japanese gastric cancer treatment guidelines. Patient characteristics, outcomes of ESD procedures, and long-term outcomes were analyzed. Results: A total of 31 patients (2 females; median age, 73 years) with 45 GTC cases were treated with ESD. The mean period from esophagectomy to the diagnosis of GTC was 10.6 years. The only adverse event due to ESD was bleeding (2 patients: 6.5%). No fatal events, such as perforation, occurred. The rates of complete resections and curative resections were 80.6% and 48.4%, respectively. The 3-year and 5-year overall survival rates were 67.6% and 47.7%, respectively. The 3-year and 5-year disease-specific survival rates were 100% and 92.9%, respectively. One patient died of GTC and 14 patients died of other diseases, including five primary carcinomas. Conclusions: ESD for GTC can be a safe treatment and contribute to positive long-term outcomes. Long-term regular gastroscopy is required for early detection. Moreover, additional care should be given to GTC patients who are at high risk for other primary carcinomas or comorbidities.

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Advanced feasibility of endoscopic submucosal dissection for the treatment of gastric tube cancer after esophagectomy

Cited by 14 publications

References 13 publications

Distal gastric tube resection with vascular preservation for gastric tube cancer: A case report and review of literature

Distal gastric tube resection with vascular preservation for gastric tube cancer: A case report and review of literature

Endoscopic Submucosal Dissection for Gastric Tube Carcinoma After Esophagectomy Contributes to Long-Term Outcomes: A Retrospective Case Series

Endoscopic submucosal dissection for gastric tube carcinoma after esophagectomy contributes to long-term outcomes: a retrospective case series

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