浅表性食管鳞状细胞瘤内镜下黏膜下剥离术后的五年生存率。
The five-year survival rate after endoscopic submucosal dissection for superficial esophageal squamous cell neoplasia.
作者信息
Nagami Yasuaki, Ominami Masaki, Shiba Masatsugu, Minamino Hiroaki, Fukunaga Shusei, Kameda Natsuhiko, Sugimori Satoshi, Machida Hirohisa, Tanigawa Tetsuya, Yamagami Hirokazu, Watanabe Toshio, Tominaga Kazunari, Fujiwara Yasuhiro, Arakawa Tetsuo
机构信息
Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.
出版信息
Dig Liver Dis. 2017 Apr;49(4):427-433. doi: 10.1016/j.dld.2016.12.009. Epub 2016 Dec 21.
BACKGROUND
Endoscopic submucosal dissection (ESD) is a widely accepted procedure for superficial esophageal squamous cell neoplasia (ESCN) because of a high complete resection rate. However, there were a few reports about the long-term outcomes of these patients due to short follow-up periods.
AIMS
We aimed to evaluate the 5-year survival after ESD for superficial ESCN.
METHODS
This was a retrospective cohort study performed at a single institution. Between 2006 and 2009, 94 patients with superficial ESCN underwent ESD. Eighty-three patients (93.3%) who had completed an extended period of observation of at least 5 years were enrolled. The main outcomes were the 5-year survival rates. The secondary outcomes were the cumulative incidence rate of metachronous ESCN, and the clinical outcomes.
RESULTS
The 5-year relative overall survival rate was 99.0%, whereas the cause specific survival rate was 100% during 72.9 months of median follow up period. Subgroup analysis showed that the 5year survival of patients with EP/LPM and MM/SM1 (submucosal invasion ≤200μm) were 100% and 89.0%, respectively. The cumulative incidence rate of metachronous ESCN at 5 years was 16.8%.
CONCLUSION
ESD for superficial ESCN is a curative treatment with a favorable 5-year survival rate.
背景
内镜黏膜下剥离术（ESD）因其高完全切除率而被广泛接受用于治疗浅表性食管鳞状细胞肿瘤（ESCN）。然而，由于随访期短，关于这些患者长期预后的报道较少。
目的
我们旨在评估ESD治疗浅表性ESCN后的5年生存率。
方法
这是一项在单一机构进行的回顾性队列研究。2006年至2009年间，94例浅表性ESCN患者接受了ESD治疗。纳入了83例（93.3%）完成了至少5年延长观察期的患者。主要结局是5年生存率。次要结局是异时性ESCN的累积发病率和临床结局。
结果
5年相对总生存率为99.0%，而在中位随访期72.9个月期间病因特异性生存率为100%。亚组分析显示，EP/LPM和MM/SM1（黏膜下浸润≤200μm）患者的5年生存率分别为100%和89.0%。5年时异时性ESCN的累积发病率为16.8%。
结论
ESD治疗浅表性ESCN是一种具有良好5年生存率的治愈性治疗方法。
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