Clinical Outcomes of the Endoscopic Treatments for the Early Esophageal Carcinoma and Dysplasia

Kim, Cheol; Hong, Su Jin; Han, Jae Pil; Jung, Hee Jae; Jeong, Eun Soo; Goong, Hyeon Jeong; Kim, Heejun; Lee, Seoung Ho; Ko, Bong Min; Lee, Moon Sung

Abstract

BACKGROUND/AIMS
Esophageal cancer and dysplasia are relatively rare in Korea, compared to other Far Eastern countries. So, the feasibility and safety of endoscopic treatments for these diseases is not well established in Korea. This study aimed to assess the technical feasibility, safety and the clinical outcomes of endoscopic treatment for esophageal epithelial lesions.
MATERIALS AND METHODS
Between April 2005 and March 2013, 25 esophageal epithelial lesions from 22 patients were treated with endoscopic treatment such as endoscopic submucosal dissection or endoscopic mucosal resection.
RESULTS
Of the 25 lesions, 11 lesions were treated with endoscopic submucosal dissection (ESD) (ESD group) and 14 lesions with endoscopic mucosal resection (EMR group). In the ESD group, the diagnosis was squamous cell carcinoma in 7 patients (64%), high grade dysplasia in 3 patients (27%), and low grade dysplasia in 1 patient (9%). In the EMR group, thediagnosis was squamous cell carcinoma in 8 patients (57%), high grade dysplasia in 2 patients (14%), and low grade dysplasia in 4 patients (29%). En bloc resection rates were 100% in ESD and 42.9% in EMR, respectively. For the median 12 months follow up period, there was no recurrence in the ESD group. However, there were three recurrences in the EMR group.
CONCLUSIONS
Endoscopic treatment for esophageal epithelial lesions is safe and feasible therapeutic modalities. Especially, ESD can provide higher rate of en bloc and curative resection for early esophageal cancer and dysplasia.