Clin Endosc.  2018 Sep;51(5):470-477. 10.5946/ce.2018.025.

Long-Term Survival and Tumor Recurrence in Patients with Superficial Esophageal Cancer after Complete Non-Curative Endoscopic Resection: A Single-Center Case Series

• Lee JW
• Cho CJ
• Kim DH
• Ahn JY
• Lee JH
• Choi KD
• Song HJ
• Park SR
• Lee HJ
• Kim YH
• Lee GH
• Jung HY
• Kim SB
• Kim JH
• Park SI

• KMID: 2427720
• DOI: http://doi.org/10.5946/ce.2018.025

Abstract

BACKGROUND/AIMS
To report the long-term survival and tumor recurrence outcomes in patients with superficial esophageal cancer (SEC) after complete non-curative endoscopic resection (ER).
METHODS
We retrieved ER data for 24 patients with non-curatively resected SEC. Non-curative resection was defined as the presence of submucosal and/or lymphovascular invasion on ER pathology. Relevant clinical and tumor-specific parameters were reviewed.
RESULTS
The mean age of the 24 study patients was 66.3±8.3 years. Ten patients were closely followed up without treatment, while 14 received additional treatment. During a mean follow-up of 59.0±33.2 months, the 3- and 5-year survival rates of all cases were 90.7% and 77.6%, respectively. The 5-year overall survival rates were 72.9% in the close observation group and 82.1% in the additional treatment group (p=0.958). The 5-year cumulative incidences of all cases of recurrence (25.0% vs. 43.3%, p=0.388), primary EC recurrence (10.0% vs. 16.4%, p=0.558), and metachronous EC recurrence (16.7% vs. 26.7%, p=0.667) were similar between the two groups.
CONCLUSIONS
Patients with non-curatively resected SEC showed good long-term survival outcomes. Given the similar oncologic outcomes, close observation may be an option with appropriate caution taken for patients who are medically unfit to receive additional therapy.

Keyword

Esophageal carcinoma; Endoscopic resection; Survival; Recurrence

MeSH Terms

Esophageal Neoplasms*
Follow-Up Studies
Humans
Incidence
Pathology
Recurrence*
Survival Rate

Figure

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  Fig. 1. Follow-up profile of esophageal cancer patients treated with endoscopic resection (ER). LRM, lateral resection margin; DRM, deep resection margin; RTx, radiotherapy; CCRT, concurrent chemoradiotherapy; CTx, chemotherapy.

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  Fig. 2. The 5-year overall survival (A), 5-year cumulative incidences of all cases of esophageal cancer (EC) recurrence (B), primary EC recurrence (C), and metachronous EC (D) rates in the close observation and additional treatment groups.

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