Expansion of the indications for endoscopic mucosal resection in patients with superficial esophageal carcinoma

Abstract

In patients with m3 or sm1 SEC, tumors that have lymphatic invasion, larger superficial size, and wider LMM invasion are associated with a high risk for lymph-node metastasis. EMR might be indicated for the treatment of patients with m3 or sm1 SECs without these characteristics.

Reasonable decision of anesthesia methods in patients who underwent endoscopic submucosal dissection for superficial esophageal carcinoma: A retrospective analysis in a single Japanese institution

“…It is also well known that esophageal ESD not only causes major adverse events such as emphysema but is also very time-consuming, as stated in previous reports (20,21). This indicates that ESD has a disadvantage compared with EMR, which has been shown to be a safe and simple technique requiring a relatively short period of time (22,23). The factors associated with mediastinal emphysema have been reported as the exposure of the muscular layer and lesion located in the lower part of the esophagus (24), but these have not been considered regarding anesthetic methods during ESD (25).…”

Staging accuracy of esophageal cancer by endoscopic ultrasound: A meta-analysis and systematic review

“…For example, if EUS demonstrates that a patient has T1 stage disease, the odds of having the correct anatomic stage of T1 disease is 221 to 1. This helps physicians offer endoscopic treatment with confidence to patients with early disease [81][82][83][84][85][86][87] . Another way of looking at this is: if a small lesion is found to be esophageal cancer, then EUS is an excellent diagnostic test to examine the depth of tumor invasion, because of its very high sensitivity and specificity.…”

“…Another way of looking at this is: if a small lesion is found to be esophageal cancer, then EUS is an excellent diagnostic test to examine the depth of tumor invasion, because of its very high sensitivity and specificity. The depth of tumor invasion can help decide if curative surgical or curative endoscopic mucosal resection or submucosal dissection can be offered to resect the lesion en bloc [81][82][83][84][85][86][87] .…”

“…Clinically, another viewpoint is: if EUS diagnoses T2 disease then the patient might still have anatomic T1 disease, but if EUS diagnoses T1 disease then the patient probably truly has anatomic T1 disease. This helps physicians offer surgical or endoscopic treatments with confidence if EUS diagnoses a patient with T1 esophageal cancer [81][82][83][84][85][86][87] . The major advantage of EUS is the ability to perform FNA during the procedure for tissue diagnosis.…”

Endoscopic resection of superficial gastrointestinal tumors

“…Five-year survival rate is up to 95% after EMR in patients with superficial SCC without lymph node metastasis in m1 and m2 SCC of the esophagus [16] . Recently, an expanded indication for EMR in patients with superficial esophageal carcinoma m3 or sm1 has been proposed [17] .…”