Risk of metastasis in adenocarcinoma of the esophagus: a multicenter retrospective study in a Japanese population

Ishihara, Ryu; Oyama, Tsuneo; Abe, Seiichiro; Takahashi, Hiroaki; Ono, Hiroyuki; Fujisaki, Junko; Kaise, Mitsuru; Goda, Kenichi; Kawada, Kenro; Koike, Tomoyuki; Takeuchi, Manabu; Matsuda, Rie; Hirasawa, Dai; Yamada, Masayoshi; Kodaira, Junichi; Tanaka, Masaki; Omae, Masami; Matsui, Akira; Kanesaka, Takashi; Takahashi, Akiko; Hirooka, Shinichi; Saito, Masahiro; Tsuji, Yosuke; Maeda, Yuki; Yamashita, Hiroharu; Oda, Ichiro; Tomita, Yoshihiro; Matsunaga, Takashi; Terai, Shuji; Ozawa, Soji; Kawano, Tatsuyuki; Seto, Yasuyuki

doi:10.1007/s00535-016-1275-0

Cited by 72 publications

(68 citation statements)

References 42 publications

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“…A recent study in Japan [81] validated these criteria, showing no metastases (0/186 lesions) in patients with mucosal cancer without lymphovascular involvement and a poorly differentiated component, or in patients with SM cancer (≤ 500 μm) without lymphovascular involvement, a poorly differentiated component, and ≤ 30 mm (0/32 lesions).…”

Section: Risk Of Metastasismentioning

confidence: 98%

Endoscopic diagnosis and treatment of esophageal adenocarcinoma: introduction of Japan Esophageal Society classification of Barrett’s esophagus

2018

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Endoscopic surveillance of Barrett's esophagus has become a foundation of the management of esophageal adenocarcinoma (EAC). Surveillance for Barrett's esophagus commonly involves periodic upper endoscopy with biopsies of suspicious areas and random four-quadrant biopsies. However, targeted biopsies using narrow-band imaging can detect more dysplastic areas and thus reduce the number of biopsies required. Several specific mucosal and vascular patterns characteristic of Barrett's esophagus have been described, but the proposed criteria are complex and diverse. Simpler classifications have recently been developed focusing on the differentiation between dysplasia and non-dysplasia. These include the Japan Esophageal Society classification, which defines regular and irregular patterns in terms of mucosal and vascular shapes. Cancer invasion depth is diagnosed by endoscopic ultrasonography (EUS); however, a meta-analysis of EUS staging of superficial EAC showed favorable pooled values for mucosal cancer staging, but unsatisfactory diagnostic results for EAC at the esophagogastric junction. Endoscopic resection has recently been suggested as a more accurate staging modality for superficial gastrointestinal cancers than EUS. Following endoscopic resection for gastrointestinal cancers, the risk of metastasis can be evaluated based on the histology of the resected specimen. European guidelines describe endoscopic resection as curative for well- or moderately differentiated mucosal cancers without lymphovascular invasion, and these criteria might be extended to lesions invading the submucosa (≤ 500 μm), i.e., to low-risk, well- or moderately differentiated tumors without lymphovascular involvement, and < 3 cm. These criteria were confirmed by a recent study in Japan.

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Section: Risk Of Metastasismentioning

confidence: 98%

Endoscopic diagnosis and treatment of esophageal adenocarcinoma: introduction of Japan Esophageal Society classification of Barrett’s esophagus

2018

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“…CR was defined upon satisfying the following criteria: negative horizontal margin, negative vertical margin, negative vascular invasion, and depth of submucosal invasion (SM) ≤500 μm. Invasion distance of the criteria was defined according to a recent multi-DOI: 10.1159/000486197 center retrospective study in a Japanese population about SM invasion depth and lymph node metastasis rate of esophageal adenocarcinoma [17]. As secondary endpoints, we evaluated resection duration, complications, en bloc resection rate, negative horizontal margin rate, R0 resection rate, noncurative factors, and prognosis after the first ESD including overall survival and disease-free survival rates.…”

Section: Endpointsmentioning

confidence: 99%

Treatment Outcomes of Endoscopic Submucosal Dissection for Adenocarcinoma Originating from Long-Segment Barrett’s Esophagus versus Short-Segment Barrett’s Esophagus

et al. 2018

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Background: In recent years, effective outcomes of endoscopic submucosal dissection (ESD) for esophagogastric junction cancer including short-segment Barrett’s esophagus (SSBE) cancer have been reported. However, the efficacy of ESD for long-segment Barrett’s esophagus (LSBE) cancer is unknown. Aim: To clarify the treatment outcomes of ESD for LSBE cancer versus SSBE cancer. Methods: A total of 86 patients with 91 superficial Barrett’s esophageal adenocarcinomas who underwent ESD were enrolled; of these, 68 had underlying SSBE and 18 had LSBE. Procedure outcomes and prognosis were compared. Results: There was no significant difference in age and tumor diameter among patients. The only complication observed was stricture, but it was not significant (2 vs. 9%). No significant difference was observed in the negative horizontal margin rates (94.1 vs. 95.7%), R0 resection rates (83.8 vs. 82.6%), curative resection rates (72.1 vs. 73.9%), and noncurative factors. Both LSBE and SSBE cancer showed favorable 3-year overall survival rates (95.0 vs. 94.4%) in the median observation period of 28.5 months. Conclusions: ESD for LSBE cancer achieved procedure outcomes and short-term prognosis comparable to SSBE. ESD has the potential to be an effective therapeutic option for esophageal neoplasms in patients with LSBE.

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“…In Japan, the main therapeutic approaches for EGJ adenocarcinomas are endoscopic resection and surgery. According to a recent report, endoscopic resection was carried out in over half of cases with esophageal adenocarcinomas, including EGJ adenocarcinomas, which were confined to the submucosa . Endoscopic screening and precise diagnosis may contribute to detection at an early stage.…”

Section: Situation In Japanmentioning

confidence: 99%

Different time trend and management of esophagogastric junction adenocarcinoma in three Asian countries

Hatta

Tong

Lee

et al. 2017

Digestive Endoscopy

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Esophagogastric junction (EGJ) adenocarcinoma has been on the increase in Western countries. However, in Asian countries, data on the incidence of EGJ adenocarcinoma are evidently lacking. In the present review, we focus on the current clinical situation of EGJ adenocarcinoma in three Asian countries: Japan, Hong Kong, and Malaysia. The incidence of EGJ adenocarcinoma has been reported to be gradually increasing in Malaysia and Japan, whereas it has stabilized in Hong Kong. However, the number of cases in these countries is comparatively low compared with Western countries. A reason for the reported difference in the incidence and time trend of EGJ adenocarcinoma among the three countries may be explained by two distinct etiologies: one arising from chronic gastritis similar to distal gastric cancer, and the other related to gastroesophageal reflux disease similar to esophageal adenocarcinoma including Barrett's adenocarcinoma. This review also shows that there are several concerns in clinical practice for EGJ adenocarcinoma. In Hong Kong and Malaysia, many EGJ adenocarcinomas have been detected at a stage not amenable to endoscopic resection. In Japan, histological curability criteria for endoscopic resection cases have not been established. We suggest that an international collaborative study using the same definition of EGJ adenocarcinoma may be helpful not only for clarifying the characteristics of these cancers but also for improving the clinical outcome of these patients.

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Risk of metastasis in adenocarcinoma of the esophagus: a multicenter retrospective study in a Japanese population

Abstract: Mucosal and submucosal cancers (1-500 µm invasion) without risk factors have a low incidence of metastasis and may thus be good candidates for endoscopic resection.

Cited by 72 publications

References 42 publications

Endoscopic diagnosis and treatment of esophageal adenocarcinoma: introduction of Japan Esophageal Society classification of Barrett’s esophagus

Endoscopic diagnosis and treatment of esophageal adenocarcinoma: introduction of Japan Esophageal Society classification of Barrett’s esophagus

Treatment Outcomes of Endoscopic Submucosal Dissection for Adenocarcinoma Originating from Long-Segment Barrett’s Esophagus versus Short-Segment Barrett’s Esophagus

Different time trend and management of esophagogastric junction adenocarcinoma in three Asian countries

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