Korean J Gastroenterol.  2018 Mar;71(3):116-123. 10.4166/kjg.2018.71.3.116.

Endoscopic Treatment for Esophageal Cancer

• Min YW

• KMID: 2407668
• DOI: http://doi.org/10.4166/kjg.2018.71.3.116

Abstract

Esophageal cancer incidence rate per 100,000 is 4.7 in 2013, which accounts for 1.1% of the total cancer incidence in Korea. Superficial esophageal squamous cell carcinoma is frequently detected in persons undergoing upper endoscopy for gastrointestinal symptoms or for gastric cancer screening. Esophagectomy with lymph node dissection is the standard treatment for esophageal cancer. However, given the considerable morbidity and mortality of esophagectomy, endoscopic resection has become the standard of care for most cases of superficial esophageal squamous cell carcinoma without metastasis. In addition, endoscopic submucosal dissection has increased the cure rate, even when the tumor is large, compared to endoscopic mucosal resection. Thus, endoscopic submucosal dissection is the treatment of choice for superficial esophageal squamous cell carcinoma with a negligible risk of lymph node metastasis. Endoscopic resection is usually associated with a low risk of morbidity and no mortality, and has also shown favorable long-term outcomes. However, the long-term risk of metastasis remains after endoscopic resection, which varies according to the characteristics of tumor. This review describes the indication and outcomes of endoscopic resection, complications of endoscopic resection, and management after treatment.

Keyword

Endoscopic mucosal resection; Endoscopic submucosal dissection; Esophageal squamous cell carcinoma

MeSH Terms

Carcinoma, Squamous Cell
Endoscopy
Esophageal Neoplasms*
Esophagectomy
Humans
Incidence
Korea
Lymph Node Excision
Lymph Nodes
Mass Screening
Mortality
Neoplasm Metastasis
Standard of Care
Stomach Neoplasms

Figure

• 

  Fig. 1. Endoscopic submucosal dissection procedure. (A) On the lower thoracic esophagus, a 3-cm-sized geographic mucosal hyperemia with uneven surface is noticed. (B) Lugol's solution is sprayed along the lesion to aid visualization. (C) Marking around the lesion is performed. (D) After submucosal injection, circumferential mucosal pre-cutting is performed. (E) After dissection of the submucosal layer, an artificial ulcer is seen. (F) Fixation of the resected specimen.

Reference

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