Comparison of Endoscopic Resection and Minimally Invasive Esophagectomy in Patients With Early Esophageal Cancer

“…Esophagectomy is the standard treatment for EC. Radiotherapy is an effective treatment option to cure or control EC (Jin et al, 2017). Targeted therapy is a key step in the development of individualized treatment for EC.…”

Section: Introductionmentioning

confidence: 99%

m6A Regulators Is Differently Expressed and Correlated With Immune Response of Esophageal Cancer

Zhao

Xie

et al. 2021

Front. Cell Dev. Biol.

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N6 methyladenosine (m6A) RNA methylation regulators play an important role in the development of tumors. However, their function in esophageal cancer (EC) has not been fully elucidated. Here, we analyzed the gene expression data of 24 major m6A RNA methylation regulators from 775 patients with EC from TCGA dataset. The present study showed the aberrations of m6A regulators in genome were correlated to prognosis in human ECs. Meanwhile, 17 m6A regulators showed increased expression in EC samples, including YTHDC1, IGF2BP2, FTO, METTL14, YTHDF3, RBM15, WTAP, HNRNPA2B1, HNRNPC, ALKBH5, YTHDF2, METTL16, IGF2BP3, VIRMA, RBM15B, YTHDF1, KIAA1429, HAKAI, and ZC3H13. Among them, we found HNRNPC, YTHDC2, WTAP, VIRMA, IGF2BP3, and HNRNPA2B1 were significantly correlated to worse outcomes and advanced stage in EC. Furthermore, we showed levels of m6A regulators is correlated with the expression of Immuno-regulators (Immunoinhibitors, Immunostimulators, and MHC molecules) and immune infiltration levels in EC. Bioinformatics further confirm m6A regulators were involved in regulating RNA splicing, RNA stability, and cell proliferation. Our study showed m6A regulators are promising targets and biomarkers for cancer immunotherapy in EC.

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“…One study compared the two treatment modalities and found similar rates in the treatment of early esophageal cancer (R0 resection rate 94.9% vs 97.5%, P > 0.05), 3-year survival (96.6% vs 97.5%, P > 0.05), 4-year survival (91.5% vs 90%, P > 0.05) and local recurrence ( P > 0.05)[33]. However, EET was superior with fewer complications (11.8% vs 32.5%, P > 0.05), shorter operative time (74 ± 23 min vs 298 ± 46 min), hospital LOS ( P < 0.001) and recovery time compared to MIE[33]. Therefore, EET is increasingly used as it is cost effective, has minimal morbidity and mortality with excellent long-term survival comparable to esophagectomy.…”

Section: Outcomes: Eet Versus Esophagectomymentioning

confidence: 99%

Resection of early esophageal neoplasms: The pendulum swings from surgical to endoscopic management

Sanghi

Amin

Sanaka

et al. 2019

WJGE

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Esophageal cancer is a highly lethal disease and is the sixth leading cause of cancer related mortality in the world. The standard treatment is esophagectomy which is associated with significant morbidity and mortality. This led to development of minimally invasive, organ sparing endoscopic therapies which have comparable outcomes to esophagectomy in early cancer. These include endoscopic mucosal resection and endoscopic submucosal dissection. In early squamous cell cancer, endoscopic submucosal dissection is preferred as it is associated with cause specific 5-year survival rates of 100% for M1 and M2 tumors and 85% for M3 and SM1 tumors and low recurrence rates. In early adenocarcinoma, endoscopic resection of visible abnormalities is followed by ablation of the remaining flat Barrett’s mucosa to prevent recurrences. Radiofrequency ablation is the most widely used ablation modality with others being cryotherapy and argon plasma coagulation. Focal endoscopic mucosal resection followed by radiofrequency ablation leads to eradication of neoplasia in 93.4% of patients and eradication of intestinal metaplasia in 73.1% of patients. Innovative techniques such as submucosal tunneling with endoscopic resection are developed for management of submucosal tumors of the esophagus. This review includes a discussion of various endoscopic techniques and their clinical outcomes in early squamous cell cancer, adenocarcinoma and submucosal tumors. An overview of comparison between esophagectomy and endoscopic therapy are also presented.

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Comparison of Endoscopic Resection and Minimally Invasive Esophagectomy in Patients With Early Esophageal Cancer

Abstract: ER achieves the same positive results as MIE in the treatment of early esophageal cancer and is associated with a lower complication rate, a shorter recovery time, and a similar survival rate. However, multiple ER procedures were required for several patients in this study.

Cited by 13 publications

References 19 publications

Endoscopic submucosal dissection for early esophageal cancer in elderly patients with relative indications for endoscopic treatment

Endoscopic submucosal dissection for early esophageal cancer in elderly patients with relative indications for endoscopic treatment

m6A Regulators Is Differently Expressed and Correlated With Immune Response of Esophageal Cancer

Resection of early esophageal neoplasms: The pendulum swings from surgical to endoscopic management

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