Long-Term Outcome after Endoscopic Submucosal Dissection in Patients with Superficial Esophageal Squamous Cell Carcinoma: A Single-Center Study

Abstract

Background/AimsSuperficial esophageal squamous cell carcinoma (SESCC) is being increasingly detected during screening endoscopy. Endoscopic submucosal dissection (ESD) allows for en bloc and histologically complete resection of lesions. This study assessed the technical feasibility and long-term outcomes of ESD for SESCCs.MethodsBetween January 2005 and August 2012, 27 patients with 28 SESCCs underwent ESD at Pusan National University Hospital. The en bloc and pathologically complete resection rates, complication (perforation and bleeding) rate, incidence of esophageal stricture after ESD, and overall and disease-specific survival rates were evaluated.ResultsThe en bloc and pathologically complete resection rates were 93% and 83%, respectively. No significant bleeding occurred, and perforation with mediastinal emphysema was observed in two patients (7%). Post-ESD stricture occurred in two patients (7%) who had mucosal defects involving more than three-fourths of the esophageal circumference. During a mean follow-up of 23 months, local tumor recurrence was seen in two of four lesions with pathologically incomplete resection; one was treated by re-ESD, and the other was treated by surgical esophagectomy. The 5-year overall and disease-specific survival rates were 84% and 100%, respectively.ConclusionsESD seems to be a feasible, effective curative treatment for SESCCs. All patients should be closely followed after ESD.

Clinical Outcomes of Endoscopic Submucosal Dissection for Early Esophageal Squamous Cell Neoplasms: A Retrospective Single-Center Study in China

“…However, complete resection rate seemed to be lower than previously reported studies, where rates varied between 80 and 94.6% [14, 17, 20, 21]. There may be at least 1 main explanation for such a rate.…”

Does a history of head and neck cancer affect outcome of endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma?

“…Our results suggest that HNSCC background does not adversely affect the clinical outcome of patients with superficial ESCC managed by ESD. OS and complication rates were similar between the two groups and consistent with findings from previous studies [9,17,18,[20][21][22][23][24][25][26][27][28][29][30][31].…”

Efficacy of Additional Surgical Resection After Endoscopic Submucosal Dissection for Superficial Esophageal Cancer

“…Additional surgical resection cases with residual tumors after ESD, and non-additional resection cases with recurrence after ESD. However, previous studies described the safety of ESD; and the indication for ESD has gradually been expanded to larger and deeper tumors (1,2,10,11). In Japan, EC has been approved as an indication for ESD under health insurance coverage since 2008.…”