Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus

Yip, Hon-Chi; Chiu, Philip Wai Yan

doi:10.21037/jtd.2017.06.57

Cited by 23 publications

(22 citation statements)

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“…These findings suggest there may be some merit in further defining the level of rVC 5 lesions to better risk stratify patients to surgery. Unnecessary referral for surgery should be avoided as it carries significant morbidity and mortality 2–4 20 21. Based on the National Oesophago-gastric Cancer Audit 2017, 36.4% of patients reported suffering with complications caused by oesophagectomy and 21.7% after gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of the revised Vienna Classification for predicting postendoscopic resection outcomes for gastric and oesophageal neoplasms: a retrospective cohort study of patients from a UK tertiary referral centre

et al. 2020

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AimsTo review the effectiveness of the revised Vienna classification (rVC) at predicting histological outcome and defining the postendoscopic resection (ER) clinical management plan of gastro-oesophageal dysplasia and early neoplasia in a UK tertiary-centre population.MethodsThis was a retrospective cohort study between November 2011 and May 2018. 157 patients from Salford Royal NHS Foundation Trust in the UK were included. The primary outcome was the histological results of postsurgical resection (SR) specimens compared with their post-ER rVC. The secondary outcome was overall survival rates of patients with category 4.4 and 5 of the rVC.ResultsOne-hundred and thirteen patients were diagnosed with category ≥4 of the rVC. 23 patients (20.4%) were referred for additional surgery, whereas 69 patients (61.1%) were on endoscopic surveillance only. 60.9% of post-SR specimens (14/23) revealed no residual neoplasia. 78.6% of these cancer-free specimens were classed as category 5 rVC. The overall 7-year survival rate of 25 patients with category ≥4.4 was 68% with causes of mortality not linked to upper gastrointestinal neoplasia. The overall 7-year and 3-year survival rates of category 4.4 and 5 were 73.6% and 50%, respectively, although age and comorbid state played a role.ConclusionsThis study provides evidence of outcomes comparable to other reported cohorts for cases after ER in a single-centre UK population even at rVC 4.4/5. It suggests surgery may not be necessary in all cases due to the lack of residual disease and further refinement of the rVC category 5 may help guide management.

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Section: Discussionmentioning

confidence: 99%

Accuracy of the revised Vienna Classification for predicting postendoscopic resection outcomes for gastric and oesophageal neoplasms: a retrospective cohort study of patients from a UK tertiary referral centre

et al. 2020

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“…The intrapapillary capillary loops (IPCL) of esophageal mucosa demonstrate characteristic changes of tissue atypism and provide an estimate tumor depth [22,23]. In early SCC, the vascular pattern of the IPCL can be watched using high definition endoscopy, which can help to classify and predict the depth of the tumor [24].…”

Section: Indication Criteriamentioning

confidence: 99%

Endoscopic Resection for the Treatment of Superficial Esophageal Neoplasms

Kim

Jung

2020

Korean J Thorac Cardiovasc Surg

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Superficial esophageal neoplasms (SENs) are being diagnosed increasingly frequently due to the screening endoscopy and advances in endoscopic techniques. Endoscopic resection (ER) is a relatively noninvasive treatment method with low morbidity and mortality that provides excellent oncologic outcomes. Endoscopic submucosal dissection is associated with higher rates of en bloc, complete and curative resections and lower rates of local recurrence than endoscopic mucosal resection. The most serious complication of ER is stricture, the treatment and prevention of which are crucial to maintain the patient's quality of life. ER for SEN is feasible, effective, and safe and can be considered a first-line treatment for SENs in which it is technically feasible.

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“…However, there are several problems due to the use of chemicals in Lugol’s iodine, including mucosal irritation and damage of the esophagus and stomach, leading to chest pain, discomfort, and hypersensitivity. LCE has a high sensitivity but a low specificity for the detection of ESCC, leading to a high false positive rate and the need for unnecessary biopsy [2].…”

mentioning

confidence: 99%

Usefulness of Probe-Based Confocal Laser Endomicroscopy for Esophageal Squamous Cell Neoplasm

Lee

2019

Clin Endosc

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Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus

Cited by 23 publications

References 50 publications

Accuracy of the revised Vienna Classification for predicting postendoscopic resection outcomes for gastric and oesophageal neoplasms: a retrospective cohort study of patients from a UK tertiary referral centre

Accuracy of the revised Vienna Classification for predicting postendoscopic resection outcomes for gastric and oesophageal neoplasms: a retrospective cohort study of patients from a UK tertiary referral centre

Endoscopic Resection for the Treatment of Superficial Esophageal Neoplasms

Usefulness of Probe-Based Confocal Laser Endomicroscopy for Esophageal Squamous Cell Neoplasm

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