Gut Liver.  2014 Nov;8(6):612-618. 10.5009/gnl13130.

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

• Joo DC
• Kim GH
• Park DY
• Jhi JH
• Song GA

• KMID: 2070077
• DOI: http://doi.org/10.5009/gnl13130

Abstract

BACKGROUND/AIMS
Superficial 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.
METHODS
Between 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.
RESULTS
The 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.
CONCLUSIONS
ESD seems to be a feasible, effective curative treatment for SESCCs. All patients should be closely followed after ESD.

Keyword

Esophageal neoplasms; Squamous cell carcinoma; Endoscopic submucosal dissection; Outcome

MeSH Terms

Aged
Carcinoma in Situ/pathology/*surgery
Carcinoma, Squamous Cell/pathology/*surgery
Cohort Studies
Disease-Free Survival
Dissection
Esophageal Neoplasms/pathology/*surgery
Esophageal Perforation
Esophageal Stenosis
Esophagoscopy
Female
Humans
Longitudinal Studies
Male
Middle Aged
Mucous Membrane/pathology/*surgery
Neoplasm Invasiveness
Neoplasm Recurrence, Local/*pathology
Operative Time
*Postoperative Complications
Postoperative Hemorrhage
Retrospective Studies
Treatment Outcome
Tumor Burden
Esophageal Squamous Cell Carcinoma