Advantages of endoscopic submucosal dissection versus endoscopic oblique aspiration mucosectomy for superficial esophageal tumors

Urabe, Yuji; Hiyama, Toru; Tanaka, Shinji; Yoshihara, Masaharu; Arihiro, Koji; Chayama, Kazuaki

doi:10.1111/j.1440-1746.2010.06503.x

Cited by 57 publications

(26 citation statements)

References 20 publications

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“…ESD was developed for the purpose of reducing the incidence of local recurrence associated with endoscopic mucosal resection (EMR), [18][19][20][21], but local recurrence remains problematic. Takenaka et al [22] identified tumor size [30 mm, tumor location in the upper third of the stomach, and incomplete resection as factors significantly associated with local recurrence.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and management of positive horizontal margin in early gastric cancer resected by en bloc endoscopic submucosal dissection

et al. 2014

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Background Although endoscopic submucosal dissection (ESD) is a widely accepted treatment for early gastric cancer (EGC), there is no consensus regarding the management of positive horizontal margin (HM) despite en bloc ESD. The aim of the current study was to identify the risk factors and optimal management of positive HM in EGCs resected by en bloc ESD. Methods A total of 890 consecutive patients with 1,053 intramucosal EGCs resected by en bloc ESD between April 2005 and June 2011. Clinicopathological data were retrieved retrospectively to assess the positive HM rate, local recurrence rate, risk factors for positive HM, and outcomes of treatment for local recurrent tumor. Positive HM was defined as a margin with direct tumor invasion (type A), the presence of cancerous cells on either end of 2-mm-thick cut sections (type B), or an unclear tumor margin resulting from crush or burn damage (type C).Results The positive HM rate was 2.0 % (21/1,053). The local recurrence rate was 0.3 % (3/1,053). All local recurrent tumors were intramucosal carcinomas, and were resected curatively by re-ESD. Multivariate analysis with logistic regression showed tumor location in the upper third of the stomach and lesions not matching the absolute indication to be independent risk factors for positive HM. Conclusion The risk factors for HM positivity in cases of EGC resected by en bloc ESD are tumor location in the upper third of the stomach and dissatisfaction of the absolute indication for curative ESD.

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Section: Discussionmentioning

confidence: 99%

Risk factors and management of positive horizontal margin in early gastric cancer resected by en bloc endoscopic submucosal dissection

et al. 2014

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“…28 One EMR session allows resection of limited size, and it is difficult to perform, especially at sites with cartilage protrusions. 29,30 Thus, EMR is performed piecemeal in many patients, but with piecemeal resection, histologic evaluation of the tumor margin is often difficult, whereas en bloc resection allows for careful checking of the tumor margin and accurate histologic assessment. Piecemeal resection of esophageal and gastric tumors seems to lead to a significantly higher local recurrence rate.…”

Section: Discussionmentioning

confidence: 99%

Clinical features of pharyngeal intraepithelial neoplasias and outcomes of treatment by endoscopic submucosal dissection

Kuwabara

Hiyama

Oka

et al. 2012

Gastrointestinal Endoscopy

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“…During the median observation of 65 months, ESD gave fewer local recurrence compared with EMR [78]. Another report also demonstrated that larger superficial esophageal tumors (>15 mm) should be treated with ESD to reduce local recurrence [79].…”

Section: Endoscopic Resection (Er)mentioning

confidence: 99%

“…Some reports demonstrate that ESD may be associated with a higher risk of strictures and an esophageal perforation rate compared with EMR [80], however, in comparative medical center, these complication rates did not differ significantly [77][78][79]. Most complications can be readily dealt with by endoscopic dilatation or clips.…”

Section: Endoscopic Resection (Er)mentioning

confidence: 99%

New Endoscopic Diagnosis and Treatment Options for Early Esophageal Cancer

Li¹,

Zhong²

2012

J Gastrointest Digest Sys

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Recent advances in endoscopic technology have increased detection rates of early esophageal cancer. Novel imaging techniques, such as narrow band imaging, autofluorescence imaging, confocal laser endomicroscopy and optical coherence tomography, have been recently introduced that may be taking us closer to the "optical biopsy" for dignosis of esophageal lesions. Along with the increased endoscopic detection rates, more and more early esophageal lesions have been also treated by endoscopic options. There are now long-term randomized controlled data concerning the effectiveness of ablative approaches (photodynamic therapy, cryotherapy and radiofrequency ablation); however, the ablation does not provide a tissue specimen for histopathological assessment. Unlike ablative techniques, endoscopic resection permits histopathological assessment, similar to surgery. As a new resection technique, endoscopic submucosal dissection results in complete eradication of all diseases and may translate to a lower recurrence rate than conventional endoscopic mucosal resection procedure.

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Advantages of endoscopic submucosal dissection versus endoscopic oblique aspiration mucosectomy for superficial esophageal tumors

Abstract: Although increased operation time with ESD remains problematic, SET > 15 mm should be treated with ESD to reduce local recurrence. In lesions ≤ 15 mm, EOAM might be preferable, especially in high-risk patients.

Cited by 57 publications

References 20 publications

Risk factors and management of positive horizontal margin in early gastric cancer resected by en bloc endoscopic submucosal dissection

Risk factors and management of positive horizontal margin in early gastric cancer resected by en bloc endoscopic submucosal dissection

Clinical features of pharyngeal intraepithelial neoplasias and outcomes of treatment by endoscopic submucosal dissection

New Endoscopic Diagnosis and Treatment Options for Early Esophageal Cancer

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