Superficial esophageal cancer: multicenter analysis of results of definitive radiation therapy in Japan.

Okawa, Tomohiko; Tanaka, Masanao; Kita-Okawa, Midori; Nishio, Makoto; Kikuchi, Yuji; Shirato, Hiroyuki; Yamada, Shigeru; Asakawa, Hiroshi; Niibe, Hideo; Dokiya, Takushi

doi:10.1148/radiology.196.1.7784580

Cited by 46 publications

(24 citation statements)

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“…They concluded that CRT resulted in comparable survival rates as conventional surgery for patients with superficial ESCC. Another Japanese multi-institutional study revealed that the 2-year local control rate was 83% in 105 patients with superficial ESCC treated with radiotherapy; 22 of these 105 patients had local recurrence within the radiation fields (15). Thus, previous studies have demonstrated sufficient efficacy for CRT in the control of local recurrence in patients with superficial ESCC.…”

Section: Discussionmentioning

confidence: 99%

Combination of endoscopic submucosal dissection and chemoradiation therapy for superficial esophageal squamous cell carcinoma with submucosal invasion

Mochizuki

Saito

Tsujikawa

et al. 2011

Experimental and Therapeutic Medicine

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Abstract. The efficacy, safety and clinical outcomes of a combination of endoscopic submucosal dissection (ESD) with subsequent chemoradiation therapy (CRT) for superficial esophageal squamous cell carcinomas (superficial ESCC) remain unclear. We assessed the outcome of the combination of ESD plus CRT for superficial ESCC. Fourteen patients with superficial ESCC invading into the muscularis mucosa or submucosa were treated with ESD plus CRT from 2004 to 2010. En bloc resection of the lesion was successfully performed in all patients. The mean diameter of the lesions was 25 mm (range 10-55). The distribution of the depth of tumor invasion was to the muscularis mucosa in 8 patients, to the upper submucosal third (sm1) in 4 patients and to the middle submucosal third (sm2) in 2 patients. The laterally resected margins and vascular invasion were cancer-negative in all patients, but lymph node involvement was detected in 2 patients. The mean follow-up period after CRT was 45 months (range 19-70). No patients died of esophageal cancer. Recurrence or metastasis of the esophageal cancer was not observed in any of the patients. The combination of ESD plus CRT is effective for superficial ESCC.

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Section: Discussionmentioning

confidence: 99%

Combination of endoscopic submucosal dissection and chemoradiation therapy for superficial esophageal squamous cell carcinoma with submucosal invasion

Mochizuki

Saito

Tsujikawa

et al. 2011

Experimental and Therapeutic Medicine

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“…CRT plays a role in the esophageal cancer treatment through the control of local and distant recurrences and is considered to be one of the more effective modalities for early and advanced esophageal carcinomas (26). Several multi-institutional studies reported a 2-year local control rate of 70-80% and a 3-year survival rate of 71-83% in superficial esophageal cancers treated with CRT, although 20-22% of the patients had local relapses within the radiation field (26,27). These findings of these studies indicate that CRT is less toxic than surgery, but insufficient for the local relapse control.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Submucosal Dissection (ESD) with Additional Therapy for Superficial Esophageal Cancer with Submucosal Invasion

et al. 2015

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Objective The standard treatment for submucosal esophageal cancer is esophagectomy or chemoradiotherapy (CRT). However, these treatment modalities could deteriorate the general condition and quality of life of the patients who are intolerant to invasive therapy. It is therefore important and beneficial to develop less invasive treatment protocols for these patients. Methods The study included 43 patients who were clinically suspected of mucosa or submucosal esophageal cancer but underwent endoscopic submucosal dissection (ESD) as a primary treatment, due to the patients' poor performance statuses and/or preferences for less invasive therapy. According to the pathological findings and patient's general condition, whether the patient underwent additional treatments or remained hospitalized without additional treatments was thereafter decided for each patient. We retrospectively analyzed the outcomes of these patients. Results Fifteen patients underwent additional surgery, 11 patients underwent CRT/radiation therapy (RT) and 17 patients were followed without additional treatments. During the 3-year follow-up period, the relapsefree survival rates in the patients who received or did not receive additional treatments were 88% and 64%, respectively (95% confidence interval, 0.45-0.76, p=0.04). The relapse-free and overall survival rates in the patients with additional treatments were equivalent or superior to those described in previous reports of the standard treatments. Preceding ESD contributed to reduce the local relapse significantly to approximately 3.5% and additional CRT-related toxicities. Conclusion Preceding ESD is very effective for the local control of cancer, and useful for histologically confirming the high-risk factors of relapse, such as ! submucosal layer 2 (SM2) invasion and lymphovascular involvements. ESD with additional therapy may be a promising strategy for optimizing the selection of therapy depending on the patient's general condition.

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“…The results of this study suggest that the safety of DRT is not influenced by the patient's age. Okawa et al (15) have indicated that the effectiveness of DRT for superficial esophageal cancer is promising and that it could be an alternative to surgery. It has been shown that the safety of radical esophagectomy diminishes precipitously with age (4,16,17).…”

Section: Discussionmentioning

confidence: 99%

Clinical Features of Esophageal Cancer in the Octogenarian Treated by Definitive Radiotherapy: a Multi-institutional Retrospective Survey

Kawashima

Ikeda

Yorozu

et al. 1998

Japanese Journal of Clinical Oncology

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Background: As age-related infirmity often influences treatment options and outcome of esophageal cancer, the optimization of treatment for the elderly, especially in octogenarians, has been the subject of considerable debate. Methods: We performed a retrospective, multi-institutional survey to assess the effectof age on the outcome of definitive radiotherapy for esophageal cancer by a questionnaire sent to eight institutions in Japan. Results: Therewere362evaluable replies. Thepatients included 317 males and 45 females, with a median age of 72 years (range 35-93 years), and 96% had squamous cell carcinoma. There were30 clinical stage I, 71 stage IIA,17 stage IIB, 113 stage III and 116 stage IV cases. The stage was not specified in 16 cases. Multiple co-morbidities existed in 40°!c> of the patients who were 70 years of age or older. Therewas no statistically significant age-related difference in the incidence of adverse reactions to radiotherapy (P > 0.05). Overall survival was more significantly affected by Karnofsky Performance Statusthan by the patient's age. The influence of performance status on cumulative survival for stage I and II disease was more pronounced in patients in their 80s. Conclusion: The safety of radiotherapy for esophageal carcinoma is not influenced by the patient's age. Because the performance status strongly influenced survival, the multi-disciplinary assessment of functional status is mandatory for optimizing the choice of treatmentfor patients in their 80s with esophageal cancer.

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Superficial esophageal cancer: multicenter analysis of results of definitive radiation therapy in Japan.

Cited by 46 publications

References 0 publications

Combination of endoscopic submucosal dissection and chemoradiation therapy for superficial esophageal squamous cell carcinoma with submucosal invasion

Combination of endoscopic submucosal dissection and chemoradiation therapy for superficial esophageal squamous cell carcinoma with submucosal invasion

Endoscopic Submucosal Dissection (ESD) with Additional Therapy for Superficial Esophageal Cancer with Submucosal Invasion

Clinical Features of Esophageal Cancer in the Octogenarian Treated by Definitive Radiotherapy: a Multi-institutional Retrospective Survey

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