Gut Liver.  2015 Nov;9(6):714-719. 10.5009/gnl14142.

Treatment Strategy after Endoscopic Resection of Superficial Esophageal Squamous Cell Carcinoma: A Single Institution Experience

• Lee HJ
• Lee H
• Park JC
• Shin SK
• Lee SK
• Lee YC

• KMID: 2377927
• DOI: http://doi.org/10.5009/gnl14142

Abstract

BACKGROUND/AIMS
The aim of this study was to analyze and propose a treatment strategy after endoscopic resection of superficial esophageal squamous cell carcinoma in a single institution.
METHODS
This is a retrospective review of 37 patients who were treated by endoscopic resection during a 6-year period.
RESULTS
The mean tumor size was 11.5+/-5.5 mm (range, 3 to 31 mm). Thirty-one lesions (83.8%) were treated by endoscopic submucosal dissection, and six lesions were treated by endoscopic mucosal resection (16.2%). The en bloc resection rate and complete resection rate were 91.9% and 81.8%, respectively. The tumor invasion depth was diagnosed as epithelial in five cases (13.5%), lamina propria mucosa in 12 cases (32.4%), muscularis mucosa in 10 cases (27.0%) and submucosa in 10 cases (27.0%). The complication rate was 13.5% and included three cases (8.1%) of perforation. Ten patients who had muscularis mucosa and submucosa lesions received additional treatments, including six patients who were treated with esophagectomy, three patients who were treated with radiotherapy and one patient who was treated with chemoradiotherapy. One patient with lamina propria lesions received radiotherapy due to a positive resection margin. The median follow-up duration was 22 months (range, 4 to 79 months), and no recurrence or metastasis was noted during follow-up.
CONCLUSIONS
Tailored management after endoscopic treatment of superficial esophageal squamous cell carcinoma can offer an acceptable oncologic outcome in early esophageal carcinoma.

Keyword

Endoscopic resection; Treatment strategy; Superficial esophageal squamous cell carcinoma

MeSH Terms

Aged
Aged, 80 and over
*Antineoplastic Protocols
Carcinoma, Squamous Cell/*pathology/*therapy
Chemoradiotherapy
Combined Modality Therapy
Dissection
Esophageal Neoplasms/*pathology/*therapy
Esophagectomy
*Esophagoscopy
Female
Humans
Male
Middle Aged
Mucous Membrane/pathology
Neoplasm Invasiveness
Neoplasm Recurrence, Local
*Postoperative Care
Postoperative Period
Retrospective Studies
Treatment Outcome
Tumor Burden
Esophageal Squamous Cell Carcinoma