Lee Hyun Jik, Lee Hyuk, Park Jun Chul, Shin Sung Kwan, Lee Sang Kil, Lee Yong Chan
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
Gut Liver. 2015 Nov 23;9(6):714-9. doi: 10.5009/gnl14142.
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.
This is a retrospective review of 37 patients who were treated by endoscopic resection during a 6-year period.
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.
Tailored management after endoscopic treatment of superficial esophageal squamous cell carcinoma can offer an acceptable oncologic outcome in early esophageal carcinoma.
背景/目的：本研究旨在分析并提出在单一机构中对浅表性食管鳞状细胞癌进行内镜切除术后的治疗策略。
这是一项对37例在6年期间接受内镜切除治疗的患者的回顾性研究。
肿瘤平均大小为11.5±5.5毫米（范围为3至31毫米）。31个病变（83.8%）采用内镜黏膜下剥离术治疗，6个病变采用内镜黏膜切除术治疗（16.2%）。整块切除率和完全切除率分别为91.9%和81.8%。肿瘤浸润深度诊断为上皮层5例（13.5%）、黏膜固有层12例（32.4%）、黏膜肌层10例（27.0%）和黏膜下层10例（27.0%）。并发症发生率为13.5%，包括3例（8.1%）穿孔。10例有黏膜肌层和黏膜下层病变的患者接受了额外治疗，其中6例接受了食管切除术，3例接受了放疗，1例接受了放化疗。1例黏膜固有层病变患者因切缘阳性接受了放疗。中位随访时间为22个月（范围为4至79个月），随访期间未发现复发或转移。
浅表性食管鳞状细胞癌内镜治疗后的个体化管理可为早期食管癌提供可接受的肿瘤学结局。
