Effectiveness and safety of endoscopic aspiration mucosectomy and endoscopic submucosal dissection in patients with superficial esophageal squamous-cell carcinoma

Furue, Yasuaki; Katada, Chikatoshi; Tanabe, Satoshi; Ishido, Kenji; Kondo, Yuki; Kubota, Yo; Kawanishi, Natuko; Yamane, Sakiko; Watanabe, Akinori; Moriya, Hiromitsu; Yamashita, Keishi; Wada, Takuya; Yano, Takafumi; Azuma, Mizutomo; Koizumi, Wasaburo

doi:10.1007/s00464-018-6418-3

Cited by 12 publications

(17 citation statements)

References 24 publications

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“…7,10,12,18 In contrast, the curative resection rate was as low as 19.1% by Takeuchi et al 31 In terms of the adverse events, the most commonly reported with ESD were perforation/mediastinal emphysema (3.4%), bleeding (2.0%), and stricture formation (9.4%). 5,6,8,10,[12][13][14][15][16][17][18][19][20][21][22][28][29][30][31] While they were exclusively managed by conservative treatment, repeated dilatation was often required for the latter. Moreover, the incidence and sessions of endoscopic balloon dilatation significantly increased with cervical lesions or lesions exceeded 75% of circumference.…”

Section: Baseline Characteristics Of Included Studies and Patientsmentioning

confidence: 99%

“…16 Survival analysis, local recurrence and metastasis of ESD The survival, recurrence and lymph node meta stasis rates are summarized in Table 2. Pooled overall survival rates for ESD was 90.5% at 3 years 6,7,[10][11][12][13]19,21,22,28,30 and 87.3% at 5 years [95% CI = 83.5-91.1%; Figure 2(a)]. 6,7,10,[12][13][14][19][20][21][22]28,30,31 Disease-specific survival was 98.7 at 3 years [13][14][15]17,19,21,22,28 and 97.7% at 5 years [95% CI = 95.9-99.5%; Figure 2(b)].…”

Section: Baseline Characteristics Of Included Studies and Patientsmentioning

confidence: 99%

“…Pooled overall survival rates for ESD was 90.5% at 3 years 6,7,[10][11][12][13]19,21,22,28,30 and 87.3% at 5 years [95% CI = 83.5-91.1%; Figure 2(a)]. 6,7,10,[12][13][14][19][20][21][22]28,30,31 Disease-specific survival was 98.7 at 3 years [13][14][15]17,19,21,22,28 and 97.7% at 5 years [95% CI = 95.9-99.5%; Figure 2(b)]. [5][6][7]10,12,14,[16][17][18][19]21,22,28,30 In addition, the 5-year overall survival for ESD was significantly better for M1-M2 lesions compared with deeper invasions [93.5% versus 85.1%, OR = 0.27, 95% CI = 0.15-0.49; Figure 2(c)].…”

Section: Baseline Characteristics Of Included Studies and Patientsmentioning

confidence: 99%

“…Recently, several groups from East Asia and Europe reported satisfactory overall and disease-specific survival of ESD up to 5 years, 10–20 and the latest studies suggested similar oncologic outcomes compared to esophagectomy. 21,22 Therefore, it is time to further explore the survival outcomes and safety with the different treatment modality to determine the optimal approach for the patients.…”

Section: Introductionmentioning

confidence: 97%

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Long-term outcomes of endoscopic submucosal dissection and comparison to surgery for superficial esophageal squamous cancer: a systematic review and meta-analysis

Yeh

Huang

Lee

et al. 2020

Therap Adv Gastroenterol

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Aim: The aim of this study was to investigate the long-term outcomes of endoscopic submucosal dissection (ESD) for superficial esophageal squamous cancer. Methods: A literature search was conducted using PubMed, ProQuest and Cochrane Library databases. Primary outcomes were overall survival, disease-specific survival and recurrence-free survival at 5 years. Secondary outcomes included adverse events, recurrence and metastasis. Hazard ratios were calculated based on time to events for survival analysis, and odds radios were used to compare discrete variables. Results: A total of 3796 patients in 21 retrospective studies, including 5 comparative studies for ESD and esophagectomy were enrolled. The invasion depth was 52.0% for M1–M2, 43.2% for M3–SM1 and 4.7% for SM2 or deeper. The 5-year survival rate was: overall survival 87.3%, disease-specific survival 97.7%, and recurrence-free survival 85.1%, respectively. Pooled local recurrence of ESD was 1.8% and metastasis was 3.3%. In terms of the comparison between ESD and esophagectomy, there was no difference in the overall survival (86.4% versus 81.8%, hazard ratio = 0.66, 95% CI = 0.39–1.11) as well as disease-specific and recurrence-free survival. In addition, ESD was associated with fewer adverse events (19.8 % versus 44.0%, odds ratio = 0.3, 95% CI = 0.23–0.39). Conclusions: For superficial esophageal squamous cancer, ESD may be considered as the primary treatment of for mucosal lesions, and additional treatment should be available for submucosal invasive cancers.

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Section: Baseline Characteristics Of Included Studies and Patientsmentioning

confidence: 99%

Section: Baseline Characteristics Of Included Studies and Patientsmentioning

confidence: 99%

Section: Baseline Characteristics Of Included Studies and Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

See 2 more Smart Citations

Long-term outcomes of endoscopic submucosal dissection and comparison to surgery for superficial esophageal squamous cancer: a systematic review and meta-analysis

Yeh

Huang

Lee

et al. 2020

Therap Adv Gastroenterol

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“… 1 2 To overcome the challenges of the inevitable morbidity and mortality associated with radical esophageal resection, endoscopists have been successfully using endoscopic resection as a minimally invasive treatment in recent years. 1 2 3 4 However, endoscopic resection with curative intent is indicated only for mucosal invasive tumors because these tumors rarely metastasize to the lymph nodes. 5 Therefore, accurate prediction of invasion depth in SESC is crucial for making a proper decision on the treatment strategy.…”

Section: Introductionmentioning

confidence: 99%

Novel Endoscopic Criteria for Predicting Tumor Invasion Depth in Superficial Esophageal Squamous Carcinoma

et al. 2020

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Background Accurate prediction of tumor invasion depth in superficial esophageal squamous carcinoma (SESC) is essential for deciding the appropriate treatment strategy. We proposed novel endoscopic criteria to differentiate between mucosal and submucosal esophageal cancers and to evaluate the diagnostic accuracy and usefulness of the criteria. Methods A total of 352 patients who underwent endoscopic or surgical resection for SESC between 1991 and 2010 were included. First, the novel endoscopic criteria were created based on the endoscopic features of 60 randomly selected patients as follows: for T1m cancers, I. flat or slightly elevated or depressed lesion with smooth/even surface of any size, II. slightly elevated lesion of ≤ 1 cm with granular or uneven surface, III. hyperemic flat lesion of ≤ 3 cm with granular or uneven surface, IV. slightly depressed lesion of ≤ 2 cm with uneven surface and for T1sm cancers, I. irregularly (unevenly) nodular or protruded lesion of any size, II. slightly elevated lesion of > 1 cm with granular or uneven surface, III. hyperemic flat lesion of > 3 cm with granular or uneven surface, IV. irregularly (unevenly) depressed lesion of > 2 cm, and V. ulcerative lesion of any size. Next, the endoscopic findings of the remaining 292 patients were reviewed according to the criteria. Results The accuracy of novel endoscopic criteria was 79.5% (232/292). The sensitivity and specificity of mucosal cancers were 78.4% and 81.0%, respectively, whereas those for submucosal cancers were 81.0% and 78.4%, respectively. The accuracy for mucosal cancers was high (97.3%, 72/74) when the lesions were flat or slightly elevated/depressed with smooth/even surface regardless of size, whereas that for submucosal cancers was high (85.7%, 18/21) when the lesions were irregular/nodular protrusions regardless of size. In multivariate analysis, macroscopic type IIb lesion was identified as an independent factor affecting accuracy ( P < 0.05). The difference in recurrence-free survival rates between endoscopically mucosal and submucosal cancers was significant ( P = 0.026). Conclusion The novel endoscopic criteria appear to be accurate and useful in predicting invasion depth in SESC. Our criteria might help not only to decide the treatment strategy between surgery and endoscopic resection but also to predict the outcomes of SESC.

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Transoral surgery for superficial head and neck cancer: National Multi‐Center Survey in Japan

et al. 2021

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Effectiveness and safety of endoscopic aspiration mucosectomy and endoscopic submucosal dissection in patients with superficial esophageal squamous-cell carcinoma

Abstract: ESD has a higher en bloc complete resection rate and a better local control rate than EAM. For lesions measuring less than 15 mm in diameter, EAM may be a treatment option.

Cited by 12 publications

References 24 publications

Long-term outcomes of endoscopic submucosal dissection and comparison to surgery for superficial esophageal squamous cancer: a systematic review and meta-analysis

Long-term outcomes of endoscopic submucosal dissection and comparison to surgery for superficial esophageal squamous cancer: a systematic review and meta-analysis

Novel Endoscopic Criteria for Predicting Tumor Invasion Depth in Superficial Esophageal Squamous Carcinoma

Transoral surgery for superficial head and neck cancer: National Multi‐Center Survey in Japan

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