Radiation therapy alone for stage I (UICC T1N0M0) squamous cell carcinoma of the esophagus: Indications for surgery or combined chemoradiotherapy

Ishikawa, Hitoshi; Sakurai, Hideyuki; Tamaki, Yasuhiro; Nonaka, Tetsuo; Yamakawa, Michitaka; Saito, Yoshihiro; Kitamoto, Yoshizumi; Higuchi, Keiko; Hasegawa, Masatoshi; Nakano, Takashi

doi:10.1111/j.1440-1746.2006.04089.x

Cited by 32 publications

(26 citation statements)

References 36 publications

(126 reference statements)

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“…A recent retrospective report by the Japanese Society of Therapeutic Radiology and Oncology Study Group did not validate the efficacy of IBT (16). Alternatively, our interim report demonstrated that both local control and survival rates for patients treated with external-beam radiotherapy (EBRT) combined with IBT were superior to those of patients treated with EBRT alone, but the difference did not reach a significance level (21). There were several shortcomings in the report, which would be addressed by (1) longer follow-up, (2) larger population size, and (3) adjustment of the difference in treatment periods between the group treated with EBRT alone and the group treated with EBRT plus IBT.…”

Section: Introductioncontrasting

confidence: 49%

Usefulness of Intraluminal Brachytherapy Combined With External Beam Radiation Therapy for Submucosal Esophageal Cancer: Long-Term Follow-Up Results

Ishikawa

Nonaka

Sakurai

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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Section: Introductioncontrasting

confidence: 49%

Usefulness of Intraluminal Brachytherapy Combined With External Beam Radiation Therapy for Submucosal Esophageal Cancer: Long-Term Follow-Up Results

Ishikawa

Nonaka

Sakurai

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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“…Aucun de ces patients n'avait eu de traitement complémentaire (chimiothérapie, radiothérapie ou chirurgie) après l'EMR. Dans la littérature, les patients ayant des lésions pT1 traitées par radiochimiothérapie sans EMR au préalable ont une survie comprise entre 70 et 79 % [30][31][32][33]. Dans notre étude, les patients ont tous eu une EMR, et la survie est supérieure à 90 %.…”

Section: Discussionunclassified

Évolution favorable à long terme des patients traités par résection muqueuse endoscopique pour une dysplasie de haut grade ou un cancer épidermoïde superficiel de l’œsophage

et al. 2011

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“…Treatment selection for m3 or sm1 esophageal cancer include EMR/ESD, surgery and chemoradiotherapy. a search was conducted on PubMed for treatments using the keywords: superficial (or early) esophageal cancer, EMR, surgery and radiation for the period 1998-2008, and the results are shown in Table V ( [20][21][22]. No report discussed the long-term outcome of chemoradiation; thus Table V includes findings on only radiation.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatments for squamous cell carcinoma of the esophagus reaching to the muscularis mucosa or the upper third of the submucosal layer

Ozawa¹,

Saikawa²,

Kitagawa³

2010

Oncology Letters

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Abstract.We studied the surgical treatments of patients with either esophageal cancer reaching to the muscularis mucosae (m3) or with a slight invasion of the submucosa (sm1). We reviewed the records and examined the clinicopathological features of 29 patients with m3 or sm1 esophageal squamous cell carcinoma who had undergone surgery. Lymph node metastasis was noted in 6.3% (1 patient) of patients with m3 cancers and in 38.5% (5 patients) of those with sm1 cancers. The incidence of lymph node metastasis was higher in the sm1 than in the m3 group, but the difference was not significant. Lymphatic invasion (ly) was noted in 12.3% (2 patients) of patients with m3 cancers and in 53.8% (7 patients) of those with sm1 cancers. The incidence of ly was significantly higher in the sm1 group than in the m3 group (P<0.05). In a multivariate analysis of factors for predicting lymph node metastasis, the presence of ly was the only significant predictor (P<0.05). The preoperative diagnostic accuracies of endoscopic ultrasonography (EUS), esophagogastroduodenoscopy (EGD) and an upper gastrointestinal series (UGS) for predicting depth of invasion were 27.8, 31.0 and 41.4%, respectively, with the majority of the misdiagnoses being overestimations. In conclusion, we suggested that ly is associated with lymph node metastasis in m3 or sm1 esophageal cancer. This association is significant for treatment-related decision making. IntroductionRecent diagnostic developments have led to the detection of superficial esophageal cancer. Consequently, an increase in the number of candidates for endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) has been noted. Esophageal cancers extending to the intraepithelium (m1) or lamina propria (m2), in particular, rarely have lymph node metastasis or lymphatic invasion (ly) and are thus curative by local treatment and suitable for treatment with EMR/ ESD (1,2). On the other hand, the frequency of lymph node metastasis from cancer of the muscularis mucosa (m3) or the upper third of the submucosal layer (sm1) is 18.0 and 53.1%, respectively (3). In certain cases local treatment alone would be adequate; however, in other cases treatment for lymph node metastasis would need to be considered. Treatment strategies for m3 and sm1 cancers remain controversial. To provide appropriate treatment for these types of cancer, it would be useful to be able to identify patients that need treatment for lymph node metastasis. Diagnosis of lymph node metastasis from esophageal cancer by computed tomography (CT), ultrasonography and FDG-PET currently lacks accuracy. Subsequently, the accurate diagnosis of esophageal cancer prior to treatment presents a challenge. Depth of superficial esophageal cancer is normally diagnosed using endoscopy, endoscopic ultrasonography and a gastrointestinal series. However, despite the availability of these current modalities, accurate diagnosis of tumor depth remains difficult. If a clear diagnosis prior to treatment for m3 and sm1 esophageal cancer and accurate ...

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Radiation therapy alone for stage I (UICC T1N0M0) squamous cell carcinoma of the esophagus: Indications for surgery or combined chemoradiotherapy

Abstract: RT was a successful treatment for stage I esophageal cancer, and the treatment outcome using RT was nearly comparable to that of surgery. However, it is suggested that chemo-radiation should be considered in inoperable cases of submucosal cancer when the tumor is more than 5 cm in length.

Cited by 32 publications

References 36 publications

Usefulness of Intraluminal Brachytherapy Combined With External Beam Radiation Therapy for Submucosal Esophageal Cancer: Long-Term Follow-Up Results

Usefulness of Intraluminal Brachytherapy Combined With External Beam Radiation Therapy for Submucosal Esophageal Cancer: Long-Term Follow-Up Results

Évolution favorable à long terme des patients traités par résection muqueuse endoscopique pour une dysplasie de haut grade ou un cancer épidermoïde superficiel de l’œsophage

Surgical treatments for squamous cell carcinoma of the esophagus reaching to the muscularis mucosa or the upper third of the submucosal layer

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