Gastroenterological Center and Department of Pathology, Yokohama City University Medical Center, Minami-ku, Yokohama, Japan.
Gastrointest Endosc. 2010 Nov;72(5):960-6. doi: 10.1016/j.gie.2010.07.030.
Endoscopic submucosal dissection (ESD) was recently introduced as a treatment option for superficial adenocarcinoma of the esophagogastric junction (EGJ); however, its long-term clinical outcomes have not been fully evaluated.
To assess the long-term outcomes of ESD for patients with superficial adenocarcinoma of the EGJ.
Retrospective review from a single institution.
University hospital.
Fifty-eight patients, 46 men and 12 women (mean 69.3 years), with 39 T1m and 19 T1sm adenocarcinomas of the EGJ treated from June 2000 to May 2009.
ESD procedures were performed with typical sequences.
Complications, en bloc resection rate, curative resection rate, local recurrence, and distant metastases after ESD were evaluated. Curative resection is histologically defined as being free of resection margins and any evidence of deep submucosal invasion, undifferentiated carcinoma, and lymphovascular invasion.
There were no major complications except for 3 patients with ulcer bleeding without the need for blood transfusion and 1 patient with esophageal stenosis. The rates of en bloc resection and curative resection were 100% and 79%, respectively. Twelve resections were histologically considered noncurative; these patients underwent additional ESD (n = 1) or surgical resection (n = 8). Local or distant recurrences were not observed in any patient achieving curative resection during follow-up (median 36.6 months, range 4-94 months).
Retrospective design and single-site data collection.
Long-term outcomes after ESD are favorable. ESD may be adopted as a treatment of choice for superficial adenocarcinoma of the EGJ.
内镜黏膜下剥离术（ESD）最近被引入作为治疗食管胃交界部（EGJ）浅层腺癌的一种选择；然而，其长期临床结果尚未得到充分评估。
评估 ESD 治疗 EGJ 浅层腺癌患者的长期疗效。
单中心回顾性研究。
大学医院。
58 例患者，46 例男性和 12 例女性（平均年龄 69.3 岁），39 例 EGJ 为 T1m 腺癌，19 例为 T1sm 腺癌，于 2000 年 6 月至 2009 年 5 月接受治疗。
采用典型序列进行 ESD 操作。
评估 ESD 后的并发症、整块切除率、根治性切除率、局部复发和远处转移。根治性切除定义为无切缘和任何深部黏膜下浸润、未分化癌和血管淋巴管侵犯的组织学证据。
除 3 例患者需要输血治疗溃疡出血和 1 例患者发生食管狭窄外，无重大并发症。整块切除率和根治性切除率分别为 100%和 79%。12 例切除标本被认为是非根治性的；这些患者接受了额外的 ESD（n=1）或手术切除（n=8）。在随访期间，所有达到根治性切除的患者均未观察到局部或远处复发（中位随访时间 36.6 个月，范围 4-94 个月）。
回顾性设计和单中心数据收集。
ESD 后的长期结果是良好的。ESD 可能被采纳为 EGJ 浅层腺癌的治疗选择。
