Salvage endoscopic resection (ER) after chemoradiotherapy for esophageal squamous cell carcinoma: What are the risk factors for recurrence after salvage ER?

Abstract

Clinical findings (e.g. residual tumors found immediately after CRT and macroscopic SMT-like appearance before salvage ER) were shown to be significant risk factors for post-salvage ER recurrence.

Salvage endoscopic resection after definitive chemoradiotherapy for esophageal cancer: a Western experience

“…This is in line with previous studies showing a good safety profile for salvage ER. [17][18][19][20][21][22][23][24] No patient in our case series developed a major intra-or postprocedural bleeding or perforation, which is also comparable with rates reported after standard EMR or ESD in earlystage esophageal cancer (bleeding: EMR 3%, ESD <30%; perforation rate: EMR <1%, ESD <10%). 26,27 Esophageal strictures were seen in 4 patients (16%) after both ESD and EMR.…”

“…28 Concerns about postradiation changes in the esophageal wall, such as chronic inflammation, tissue fibrosis, and vascular damage, may well have contributed to this belief. 29,30 However, our data and that of others [17][18][19][20][21][22][23][24] suggest that concerns with respect to the complexity of salvage ER in the postradiation setting seem to be overrated (Table 4). The en-bloc resection rates of ESD were excellent, whereas EMRs had a relatively lower en-bloc resection rate.…”

“…Total dose range, 35-60 Gy Our overall survival rates were comparable with rates from earlier published single-center case series from Japan. [17][18][19][20][21][22][23][24] The largest Japanese case series of ESCC to date (n Z 72) reported a 3-year RFS, OS, and DSS of 49%, 61%, and 73%, respectively. 24 Table 4 provides a summary of published studies.…”

“…This strategy seems to be associated with promising short-and long-term survival rates with no major adverse events. [17][18][19][20][21][22][23][24] Case series from outside Japan are notably limited to 1 small case report. 25 This study is the first international collaborative initiative to collect and investigate cases of salvage ER for local failure after definitive CRT in a Western population.…”

Efficacy and safety of second photodynamic therapy for local failure after salvage photodynamic therapy for esophageal cancer

“…8 Less invasive salvage therapies such as endoscopic resection (ER) and photodynamic therapy (PDT) have recently shown high efficacy for local failure after CRT. [9][10][11][12][13][14][15] Photodynamic therapy uses a photosensitizing chemical agent that is activated by laser illumination and selectively eliminates cancer cells. 16,17 Salvage PDT with talaporfin sodium (TS) has shown acceptably high local-complete response (L-CR) rate with low frequency of complications and improved prognosis; 18,19 however, local failure occurs in some cases.…”