Outcomes of endoscopic submucosal dissection and esophagectomy for early and superficial carcinoma of the esophagus

Abstract

Background. Endoscopic resection was recommended as treatment for mucosal epithelium or lamina propria mucosae lesions not exceeding two-thirds of the circumference. The aim of this study was to verify the outcomes of endoscopic resection and surgery for early and superfi cial carcinoma of the esophagus. Methods. Endoscopic submucosal dissection (ESD) was performed for 56 cases of early and superfi cial esophageal carcinoma and esophagectomy (OP) for 35 cases, which were enrolled in this study. Treatment-related complications, site of recurrence, and cause of death were compared. Results. The complications of ESD were esophageal perforation in six cases (11%). No bleeding and one cicatricial stenosis occurred. The complications of OP were temporary hoarseness in four cases (11%), with aspiration pneumonia in three cases (9%) and anastomotic leakage in two cases (6%), all nonfatal. All early cases of ESD survived without recurrence. One of fi ve cases infi ltrating the submucosa had mediastinal lymph node recurrence and died of metastasis to the spinal cord. Nine cases of OP for lesions from the mucosal epithelium to invasion of the upper third of the submucosa survived without recurrence. Conclusions. For mucosal epithelium or lamina propria mucosae lesions, ESD was the fi rst choice of treatment. For muscularis mucosae lesions, the indication of ESD was allowable. For lesions infi ltrating the upper third of the submucosa, one of fi ve cases had lymph node recurrence after ESD, and two cases of radical esophagectomy were alive without recurrence.

Surgical Treatment for Early Esophageal Squamous Cell Carcinoma

“…However, surgery has been challenged due to high morbidity and mortality rates related to the procedure and the low rate of lymph node metastases in EEC. Less invasive approach such as limited surgical resection, organ-preserving treatment and endoscopic therapy have been developed and applied in clinic (Stein et al, 2005;Westerterp et al, 2005;Tachibana et al, 2006;Saha et al, 2009;Barbour et al, 2010;Watanabe et al, 2010).…”

A possible combined appraisal pattern: predicting the prognosis of patients after esophagectomy

“…Esophageal cancer, one of the most aggressive gastrointestinal malignancies to date and currently the sixth leading cause of cancer-associated death, is as yet experiencing an increasing trend in incidence [ 1 ]. Based on the Global Cancer Report 2020, 604,100 cases of esophageal cancer were diagnosed worldwide in 1 year, and 544,076 of them occurred due to esophageal cancer [ 2 ].…”

The Effect Of The Perioperative Waiting Time On Postoperative Survival Of Patients With Esophageal Cancer

“…Esophageal cancer is by far one of the most aggressive gastrointestinal malignancies and the sixth leading cause of cancer-related death [1] According to the National Cancer Data Center In 2015, 246,000 cases of esophageal cancer were diagnosed in China, with 188,000 deaths [2] .We comprehend that esophageal cancer is still one of the hot issues that need to be solved. Classi cation is currently based on several models, the most common of which is based on tumor location and the thoracic segment is the most common.…”