Predictors of Early and Late Mortality after Endoscopic Resection for Esophageal Squamous Cell Carcinoma

Ogata, Yohei; Hatta, Waku; Koike, Tomoyuki; Saito, Masahiro; Jin, Xun; Nakagawa, Kenichiro; Kanno, Takeshi; Uno, Kaname; Asano, Naoki; Imatani, Akira; Nakamura, Tomohiro; Nakaya, Naoki; Masamune, Atsushi

doi:10.1620/tjem.253.29

Cited by 15 publications

(14 citation statements)

References 35 publications

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“…Finally, we developed the risk classification for non‐gastric cancer‐related early and late mortality to compare the risk for gastric and non‐gastric cancer‐related mortality. Previous reports regarding upper gastrointestinal cancers set the cut‐off of early and late mortality as 3 years 14,15 . According to previous reports, about 50% of mortality occurred within 3 years after the treatment for EGC 16,17 .…”

Section: Methodsmentioning

confidence: 99%

“…Previous reports regarding upper gastrointestinal cancers set the cut-off of early and late mortality as 3 years. 14,15 According to previous reports, about 50% of mortality occurred within 3 years after the treatment for EGC. 16,17 Additionally, 3 years is one of the major indicators for the long-term prognosis in studies about gastric cancer; [18][19][20][21] thus, it might be significant to evaluate predictors for mortality before and after 3 years, separately.…”

Section: Outcome Measuresmentioning

confidence: 98%

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Predictors of early and late mortality after the treatment for early gastric cancers

Ogata

Hatta

Ohara

et al. 2021

Digestive Endoscopy

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Objectives Although many patients with early gastric cancers (EGCs) die of non‐gastric cancer‐related causes, the association of the risk categories of lymph node metastasis (LNM) with all‐cause mortality remains unclear. We aimed to clarify the predictors of early and late mortality, separately. Methods Patients with endoscopic resection or gastrectomy for EGCs between 2003 and 2017 were retrospectively enrolled. We analyzed predictors for early and late mortality, including risk categories of LNM, treatment method, and nine non‐cancer‐related indices, separately, with a cut‐off value of 3 years. Results We enrolled 1439 patients with a median follow‐up period of 79 months. The 5‐year overall survival rate was 86.8%. In the multivariate Cox analysis, the most important predictors for early and late mortality were age ≥85 years (hazard ratio [HR] 2.88 and 4.54, respectively) and Eastern Cooperative Oncology Group Performance Status ≥2 (HR 3.00 and 4.19, respectively). Charlson comorbidity index ≥2 (HR 2.76 and 1.99, respectively), American Society of Anesthesiologists Physical Status ≥3 (HR 2.35 and 1.79, respectively), and C‐reactive protein/albumin ratio ≥0.028 (HR 2.30 and 1.58, respectively) were also predictors for both early and late mortality. Male (HR 2.26), intermediate‐ (HR 2.12)/high‐risk (HR 1.85) of LNM in eCura system, and sarcopenia evaluated by the psoas muscle mass index (HR 1.70) were predictors for early mortality. Conclusion The combined assessment of multiple predictors might help to predict early and/or late mortality in patients with EGCs. The eCura system was associated with early mortality.

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Section: Methodsmentioning

confidence: 99%

Section: Outcome Measuresmentioning

confidence: 98%

Predictors of early and late mortality after the treatment for early gastric cancers

Ogata

Hatta

Ohara

et al. 2021

Digestive Endoscopy

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“…Therefore, the safety and efficacy of this method are clinically acceptable. However, it should be noted that death from adverse events, even with prophylactic CRT following non-curative ER, has been reported [ 49 ].…”

Section: Non-curative Er For Sesccmentioning

confidence: 99%

Management of Superficial Esophageal Squamous Cell Carcinoma and Early Gastric Cancer following Non-Curative Endoscopic Resection

Hatta

Koike

Uno

et al. 2022

Cancers

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According to the European and Japanese guidelines, additional treatment is recommended for cases of superficial esophageal squamous cell carcinoma (ESCC) and early gastric cancer (EGC) that do not meet the curability criteria for endoscopic resection (ER), i.e., non-curative ER, owing to the risk of lymph node metastasis (LNM). However, the rates of LNM in such cases were relatively low (e.g., 8% for EGC). Several recent advances have been made in this field. First, pathological risk stratification for metastatic recurrence following non-curative ER without additional treatment was developed for both superficial ESCC and EGC. Second, the pattern of metastatic recurrence and prognosis after recurrence following non-curative ER without additional treatment was found to be considerably different between superficial ESCC and EGC. Third, a combination of ER and selective chemoradiotherapy was developed as a minimally invasive treatment method for clinical T1b-SM ESCC. These findings may help clinicians decide the treatment strategy for patients following non-curative ER; however, for optimal therapeutic decision-making in such patients, it is also important to predict the prognosis other than SESCC or EGC and impaired quality of life. Thus, a novel algorithm that considers these factors, as well as metastatic recurrence, should be developed.

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“…Endoscopic submucosal dissection (ESD) is now widely accepted as a minimally invasive treatment method for early‐stage esophageal and gastric cancers, particularly in Eastern Asian countries. 1 , 2 , 3 , 4 , 5 , 6 In addition, many reports have shown favorable long‐term outcomes after ESD for such tumors, irrespective of the curative status, 6 , 7 , 8 , 9 , 10 , 11 and risk of lymph node metastasis or recurrence in noncurative resection. 12 , 13 , 14 , 15 , 16 …”

Section: Introductionmentioning

confidence: 99%

Recent approach for preventing complications in upper gastrointestinal endoscopic submucosal dissection

et al. 2021

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Although endoscopic submucosal dissection (ESD) is a minimally invasive treatment method for upper gastrointestinal (GI) tumors, patients undergoing upper GI ESD sometimes fall into a serious condition from complications. Thus, it is important to fully understand how to prevent complications when performing upper GI ESD. One of the major complications in esophageal and gastric ESD is intraoperative perforation. To prevent this complication, blind dissection should be avoided. Traction‐assisted ESD is a useful technique for maintaining good endoscopic view. This method was proven to reduce the incidence of intraoperative perforation, which would become a standard technique in esophageal and gastric ESD. In gastric ESD, delayed bleeding is the most common complication. Recently, a novel prediction model (BEST‐J score) consisting of 10 factors with four risk categories for delayed bleeding in gastric ESD was established, and a free mobile application is now available. For reducing delayed bleeding in gastric ESD, vonoprazan ≥20 mg/day is the sole reliable method in the current status. Duodenal ESD is still challenging with a much higher frequency of complications, such as perforation and delayed bleeding, than ESD in other organs. However, with the development of improved devices and techniques, the frequency of complications in duodenal ESD has been decreasing. To prevent intraoperative perforation, some ESD techniques, such as using the distal tips of the Clutch Cutter, were developed. An endoscopic mucosal defect closure technique would be mandatory for preventing delayed complications. However, several unresolved issues, including standardization of duodenal ESD, remain and further studies are demanded.

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Predictors of Early and Late Mortality after Endoscopic Resection for Esophageal Squamous Cell Carcinoma

Cited by 15 publications

References 35 publications

Predictors of early and late mortality after the treatment for early gastric cancers

Predictors of early and late mortality after the treatment for early gastric cancers

Management of Superficial Esophageal Squamous Cell Carcinoma and Early Gastric Cancer following Non-Curative Endoscopic Resection

Recent approach for preventing complications in upper gastrointestinal endoscopic submucosal dissection

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