Long-Term Outcome and Metastatic Risk After Endoscopic Resection of Superficial Esophageal Squamous Cell Carcinoma

Yamashina, Takeshi; Ishihara, Ryu; Nagai, Kengo; Matsuura, Noriko; Matsui, Futoshi; Ito, Takashi; Fujii, Masazumi; Yamamoto, Sachiko; Hanaoka, Noboru; Takeuchi, Yoji; Higashino, Koji; Uedo, Noriya; Iishi, Hiroyasu

doi:10.1038/ajg.2013.8

Cited by 235 publications

(232 citation statements)

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“…In cases showing tumor invasion to the muscularis mucosa (m3) or the submucosa < 200 μm from the muscularis mucosa (sm1), ER should be decided based on the risk of lymph node metastasis because the incidence of lymph node metastasis is known to be associated with the depth of invasion [23,31]. There have been efforts to expand the indications for ESD, based on reported favorable outcomes of ER for m3 or sm1 tumors [11,32,33].…”

Section: Discussionmentioning

confidence: 99%

“…However, the piecemeal resection (PR) during EMR, especially in the cases of large lesions, resulted in a high local recurrence rate of 24% to 26% [11][12][13][14][15][16][17][18][19]. Endoscopic submucosal dissection (ESD) enables en bloc resection (EnR) of SENs regardless of size [15,20], and studies regarding the long-term outcomes of ESD reported satisfactory results [21][22][23][24][25]. We previously reported the clinical outcomes of ER including EMR and ESD for esophageal neoplasm and showed favorable outcomes [26].…”

Section: Introductionmentioning

confidence: 99%

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Ten year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center.

Park

Kim

Gong

et al. 2016

JCO

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(range, 44 to 86), and the male to female ratio was 21.5:1. Median tumor size was 37 mm (range, 5 to 85) and median procedure time was 45 minutes (range, 9 to 160). En bloc resection was performed in 245 of 261 lesions (93.9%), with complete resection in 234 lesions (89.7%) and curative resection in 201 lesions (77.0%). Adverse events occurred in 33 cases (12.6%), including bleeding (1.5%), perforation (4.6%), and stricture (6.5%). During a median follow-up period of 35.0 months (interquartile range, 18 to 62), none of the patients showed local recurrence. The 5-year overall and disease-specific survival rates were 89.7% and 100%, respectively. Conclusions: ESD is a feasible and effective procedure for the treatment of SEN based on our 10-year experience, which showed favorable outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ten year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center.

Park

Kim

Gong

et al. 2016

JCO

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“…It had been reported that the rate of lymph node metastasis was low in both SCC ( 21 ) and AC ( 22 -26 ) when the lesion was limited to the SM1. In this study, four patients in the SCC group experienced local recurrence.…”

Section: Discussionmentioning

confidence: 98%

“…Similarly, in Japan, some studies suggested a favorable prognosis aft er ER for SCC of the esophagus (0 ~ 2.3 % ) ( 17,18 ), although the rates of local and metachronous recurrence were also relatively high (16.4 ~ 20 % ) ( 19,20 ). In addition, it had been reported that the rate of lymph node metastasis was low in both SCC ( 21 ) and AC ( 22 -26 ) when the lesion was limited to the superfi cial submucosa (SM1). However, few studies have simultaneously evaluated long-term outcomes of ER for SCC and AC of the esophagus in the same area.…”

Section: Introductionmentioning

confidence: 94%

Comparison of the Long-Term Outcomes of Endoscopic Resection for Superficial Squamous Cell Carcinoma and Adenocarcinoma of the Esophagus in Japan

Nakagawa

Koike

Iijima

et al. 2014

American Journal of Gastroenterology

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OBJECTIVES:Few studies have simultaneously evaluated the long-term outcomes of endoscopic resection (ER) for squamous cell carcinoma (SCC) and adenocarcinoma (AC) of the esophagus in Japan. The objective of this study was to evaluate the long-term outcomes of ER for superfi cial esophageal cancer in consecutive patients. METHODS:This was a retrospective study from a single institution. From April 2001 to June 2012, 204 patients with SCC and 26 patients with AC were included from a total of 355 consecutive patients who were treated by esophageal ER at the Tohoku University Hospital. Patients with submucosal invasion deeper than 200 μ m and lymphovascular involvement were excluded. The intervention followed was endoscopic therapy. RESULTS:Overall survival, disease-free survival, and recurrence rates were evaluated as long-term outcomes. In the SCC group, during the median observation time of 36.5 months (range, 6 -120 months), 22 (10.8 % ) patients experienced metachronous recurrence, 4 (2.0 % ) patients experienced local recurrence, and 27 (13.2 % ) patients died from causes unrelated to SCC. In the AC group, during the median observation time of 45.5 months (range, 6 -131 months), one patient (3.8 % ) experienced metachronous recurrence and two (7.7 % ) died from causes unrelated to AC. The cumulative 5-year overall survival rates were not signifi cantly different between SCC (75.9 % ) and AC (88.9 % ) ( P = 0.120). The cumulative 5-year disease-free survival rates of SCC (57.1 % ) were signifi cantly lower than those of AC (85.2 % ; P = 0.017). The cumulative 5-year recurrence rates of SCC (32.0 % ) were signifi cantly higher than those of AC (4.2 % ; P = 0.023). CONCLUSIONS:The rate of recurrence after ER was higher in patients with SCC than that in patients with AC. These fi ndings suggest that, by detecting AC of the esophagus earlier, a satisfactory prognosis without recurrence can be expected after ER in Japan, and more rigorous endoscopic follow-up is necessary after ER in patients with SCC than in those with AC.

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“…As the symptoms are usually inconspicuous, most patients have been at advanced stages when they come to the hospital. Many researchers have proven that 5-year survival rate of early esophageal squamous cell carcinoma patients who are treated by endoscopies may be more than 84% (4)(5)(6). So, it is important for the patients to be diagnosed at the early stage.…”

Section: Introductionmentioning

confidence: 99%

Fujinon intelligent color enhancement for the diagnosis of early esophageal squamous cell carcinoma and precancerous lesion

Shen²,

Yu³

et al. 2020

Turk J Gastroenterol

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Background/Aims: Esophageal squamous cell carcinoma is a common malignant tumor in recent years, and the key for improving the survival rate is early diagnosis and treatment. Computed virtual chromoendoscopy with the Fujinon intelligent color enhancement (FICE) system was reported to improve visualization of neoplastic and nonneoplastic lesions in gastroscopy and colonoscopy. The purpose of this study was to evaluate the value of FICE in the diagnosis of early esophageal squamous cell carcinoma and precancerous lesions. Materials and Methods: Two hundred fifty-seven patients with suspicious lesions of the esophagus were examined successively by FICE, magnifying FICE, Lugol chromoendoscopy, and magnifying Lugol chromoendoscopy in the hospital. The lesions and the intrapapillary capillary loop (IPCL, microvessels at the surface of esophageal carcinoma) were observed and compared with the pathologic diagnosis that was regarded as the golden standard. Results: The positive rates of early esophageal squamous cell carcinoma were 92.6% and 88.9% as examined by FICE and Lugol chromoendoscopy (p>0.05), and 96.3% and 92.6% as examined by magnifying FICE and magnifying Lugol chromoendoscopy (p>0.05), respectively. The magnifying FICE could observe the IPCL of the esophagus clearly. Early esophageal squamous cell carcinoma and high-grade intraepithelial neoplasia were mainly type IV and type V. Low-grade intraepithelial neoplasia and esophagitis were type II and type III, and normal esophagus was type I; however, the observation of the IPCL by magnifying Lugol chromoendoscopy was not clear. Conclusion: Fujinon intelligent color enhancement and magnifying FICE are complements to Lugol chromoendoscopy and magnifying Lugol chromoendoscopy in the diagnosis of early esophageal lesions.

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Long-Term Outcome and Metastatic Risk After Endoscopic Resection of Superficial Esophageal Squamous Cell Carcinoma

Abstract: The long-term risk of metastasis after ER was mainly associated with the depth of invasion. This risk should be taken into account when considering the indications for ER.

Cited by 235 publications

References 28 publications

Ten year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center.

Ten year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center.

Comparison of the Long-Term Outcomes of Endoscopic Resection for Superficial Squamous Cell Carcinoma and Adenocarcinoma of the Esophagus in Japan

Fujinon intelligent color enhancement for the diagnosis of early esophageal squamous cell carcinoma and precancerous lesion

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