A minimally invasive treatment for early GI cancers

Mejia-Perez, Lady Katherine; Abe, Seiichiro; Stevens, Tyler; Parsi, Mansour A.; Jang, Sunguk; Oda, Ichiro; Vargo, John J.; Saito, Yutaka; Bhatt, Amit

doi:10.3949/ccjm.84a.16063

Cited by 4 publications

(10 citation statements)

References 77 publications

(123 reference statements)

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“…Stricture formation mainly occurs after esophageal ESD and its rate ranges from 2% to 26% (14). The risk increases in case of long segment removal or circumferential dissection (14). As already mentioned before, esophageal stricture formation can be prevented with oral or intralesional steroids administration (20,21).…”

Section: Stricturementioning

confidence: 99%

“…The risk of lymph node metastasis is mostly associated to lesion's depth of invasion, which, therefore, needs to be carefully evaluated before the procedure. Endoscopic evaluation of tumor's depth varies upon the location along the GI tract and is based on particular imaging techniques, such as chromoendoscopy and virtual chromoendoscopy with magnification, which help in estimating not only the depth of invasion, but also lesion's microsurface and microvascular pattern (14). However, the real depth of invasion can only be assessed through the histological analysis of the resected specimen, which is of main importance to identify high-risk features requiring surgery.…”

Section: Eligibility Criteria For Esdmentioning

confidence: 99%

“…The size of the lesion is the main criterion to choose between EMR and ESD. EMR may be preferred for the removal of lesions <15 mm, as it usually has a safer profile compare to ESD (14). ESD can be considered the treatment of choice for lesions >15 mm, with poor lifting sign and for lesions possibly associated to submucosal invasion (14).…”

Section: Squamous Cell Carcinoma (Scc)mentioning

confidence: 99%

“…EMR may be preferred for the removal of lesions <15 mm, as it usually has a safer profile compare to ESD (14). ESD can be considered the treatment of choice for lesions >15 mm, with poor lifting sign and for lesions possibly associated to submucosal invasion (14). However, a meta-analysis (16) showed that even for lesions <10 mm ESD should be preferred over EMR as the recurrence rate is lower with ESD.…”

Section: Squamous Cell Carcinoma (Scc)mentioning

confidence: 99%

“…Stricture formation mainly occurs after esophageal ESD and its rate ranges from 2% to 26% (14). The risk increases in case of long segment removal or circumferential dissection (14).…”

Section: Stricturementioning

confidence: 99%

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Quality in upper gastrointestinal endoscopic submucosal dissection

2018

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Progress in the endoscopy technology field led to an increase in the diagnosis of early gastrointestinal (GI) superficial lesions and to an improvement of their treatment. Endoscopic submucosal dissection (ESD) has been developed in Japan with the aim of removing such lesions in one piece, in order to obtain a curative resection and to minimize the risk of local recurrence, and to preserve the native organ. ESD is widely used in Asia for the treatment of early upper and lower GI lesions and is currently gaining attention in Western countries too. However, ESD can be safely performed only by expert endoscopists and in specific clinical settings. Therefore, prior to decide whether ESD is feasible or not, the target lesion must be carefully assessed, in order to understand whether or not it is eligible for submucosal dissection. The aim of this paper is to review indications, limitations and technical aspects of upper GI ESD.

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Section: Stricturementioning

confidence: 99%

Section: Eligibility Criteria For Esdmentioning

confidence: 99%

Section: Squamous Cell Carcinoma (Scc)mentioning

confidence: 99%

Section: Squamous Cell Carcinoma (Scc)mentioning

confidence: 99%

“…Stricture formation mainly occurs after esophageal ESD and its rate ranges from 2% to 26% (14). The risk increases in case of long segment removal or circumferential dissection (14).…”

Section: Stricturementioning

confidence: 99%

See 3 more Smart Citations

Quality in upper gastrointestinal endoscopic submucosal dissection

2018

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Multidisciplinary Evaluation and Management of Early Stage Esophageal Cancer

Bhatt¹,

Kamath²,

Murthy³

et al. 2020

Surgical Oncology Clinics of North America

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Pathologic assessment of endoscopic resection specimens with superficial carcinoma of the esophagus: current practice and practical issues

Marginean

Jain

2020

Annals of the New York Academy of Sciences

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Endoscopic resection (ER) has become the first-line therapy for early esophageal cancer and offers a treatment alternative to surgery, owing to less morbidity and better quality of life. ER techniques include endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). EMR is faster, simpler, and cheaper than ESD, but limited by its ability to resect lesions larger than 1.5 centimeters. Piecemeal EMR has limitations, including a high local recurrence rate and a suboptimal specimen for an accurate pathologic assessment. ESD, on the other hand, allows en bloc resections with negative (R0) margins, irrespective of lesion size, providing an excellent pathologic specimen, however, is technically challenging with a higher risk of complications. The evaluation of ER specimens in pathology varies slightly from institution to institution. Our review summarizes the current practices and issues in the pathologic assessment of esophageal ER specimens, which highlights the necessity of a systematic approach and standardization of both macroscopic and microscopic evaluation. There is a need for a comprehensive and standardized pathology report that will allow for uniform terminology for endoscopists, surgeons, and pathologists, which, in turn, will result in better treatment guidance.

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A minimally invasive treatment for early GI cancers

Cited by 4 publications

References 77 publications

Quality in upper gastrointestinal endoscopic submucosal dissection

Quality in upper gastrointestinal endoscopic submucosal dissection

Multidisciplinary Evaluation and Management of Early Stage Esophageal Cancer

Pathologic assessment of endoscopic resection specimens with superficial carcinoma of the esophagus: current practice and practical issues

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