Salvage endoscopic submucosal dissection in patients with local failure after chemoradiotherapy for esophageal squamous cell carcinoma

Takeuchi, Manabu; Kobayashi, Mariko; Hashimoto, Satoru; Mizuno, Ken‐ichi; Kobashi, Gén; Sasamoto, Ryuta; Aoyama, Hidefumi; Aoyagi, Yoshinobu

doi:10.3109/00365521.2013.822092

Cited by 28 publications

(37 citation statements)

References 18 publications

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“…14,26 Moreover, it has been made available for use even in salvage ER as a feasible, effective, and safe procedure for local recurrence after definitive CRT for ESCC. 8,27,28 It is hoped that postsalvage ER pathological findings will be further elucidated with the increasing popularity of salvage ESD. Third, recurrences after salvage ER were classified in this study into locoregional recurrences and distant metastases, based on the hypothesis that risk factors for recurrence may vary between these two.…”

Section: Discussionmentioning

confidence: 99%

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

Hombu

Yano

Hatogai

et al. 2017

Digestive Endoscopy

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Section: Discussionmentioning

confidence: 99%

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

Hombu

Yano

Hatogai

et al. 2017

Digestive Endoscopy

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“…They used ESD to treat four patients with local recurrence of ESCC, and successfully achieved en bloc resection in all patients. Furthermore, Takeuchi et al [ 8 ] reported that ESD represents an acceptable treatment option for recurrent or residual ESCC involving only the submucosal layer without metastasis after CRT because of its effect in improving local control. They successfully treated 19 lesions in 19 patients who underwent salvage ESD.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Submucosal Dissection for Recurrent or Residual Superficial Esophageal Cancer after Chemoradiotherapy: Two Cases

et al. 2015

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We report two cases of endoscopic submucosal dissection (ESD) for recurrent or residual esophageal squamous cell carcinoma (ESCC) lesions after chemoradiotherapy for advanced esophageal cancer. Case 1 involved a 64-year-old man who had previously undergone chemoradiotherapy for advanced ESCC and achieved a complete response (CR) for 22 months, until metachronous recurrent superficial ESCC was detected on follow-up esophagogastroduodenoscopy (EGD). We performed ESD and found no evidence of recurrence for 24 months. Case 2 involved a 59-year-old man who had previously undergone chemoradiotherapy for advanced ESCC. He responded favorably to treatment, and most of the tumor had disappeared on follow-up EGD 4 months later. However, there were two residual superficial esophageal lugol-voiding lesions. We performed ESD, and he had a CR for 32 months thereafter. ESD can be considered a viable treatment option for recurrent or residual superficial ESCC after chemoradiotherapy for advanced esophageal cancer.

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“…Accordingly, we perform SESD in our institution. A few recent studies have reported that SESD is effective [20, 21]. They advocate consideration of SESD as a treatment option after diagnosis of esophageal superficial recurrence after dCRT for locally advanced esophageal cancer because it can achieve good local control and survival.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies, including these 2, have demonstrated that R0 resection is an important prognostic factor after salvage surgery for esophageal cancer [22-25]. That is, the most important and basic consideration with salvage operation for esophageal cancer after dCRT must be complete removal of all tumor, as indicated by outcomes of SESD after dCRT for advanced cancer [20, 21]. …”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Salvage Operations for Esophageal Cancer after Definitive Chemoradiotherapy

et al. 2018

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Background/Aims: Because salvage surgery after definitive chemoradiotherapy for esophageal cancer is associated with high postoperative mortality and morbidity, minimally invasive methods are desirable. We analyzed the validity of minimally invasive salvage operations (MISO). Methods: Twenty-five patients underwent salvage operation between 2010 and 2016 in our institution, 10 having undergone right transthoracic salvage esophagectomy (TTSE group), 6 transhiatal salvage esophagectomy (THSE), 6 salvage lymphadenectomy (SLA), and 3 salvage endoscopic submucosal dissection (SESD). Patients who had undergone THSE, SLA, or SESD were categorized as the MISO group. Short- and long-term outcomes were assessed. Results: The mean duration of surgery was significantly shorter in the SLA groups than in the TTSE group (p = 0.0248). Blood loss was significantly less in the SLA than the TTSE group (p = 0.0340). Intensive care unit stay was shorter in the THSE than the TTSE group (p = 0.0412). There was no significant difference in postoperative mortality between the MISO and THSE groups. Postoperative hospital stay was significantly shorter in the SLA than the TTSE group (p = 0.0061). Patients’ survivals did not differ significantly between the MISO and TTSE groups (p = 0.752). Multivariate analysis revealed that residual disease (R0; HR 4.872, 95% CI 1.387–17.110, p = 0.013) was the only independent factor influencing overall survival. Conclusion: MISO is preferable because short-term outcomes are better and long-term outcomes do not differ from those of TTSE.

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Salvage endoscopic submucosal dissection in patients with local failure after chemoradiotherapy for esophageal squamous cell carcinoma

Abstract: ESD represents an acceptable treatment option for recurrent or residual ESCC because of its improvement in local control, when local failure after CRT is limited to the submucosal layer without metastases.

Cited by 28 publications

References 18 publications

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

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

Endoscopic Submucosal Dissection for Recurrent or Residual Superficial Esophageal Cancer after Chemoradiotherapy: Two Cases

Minimally Invasive Salvage Operations for Esophageal Cancer after Definitive Chemoradiotherapy

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