Iizuka Toshiro, Kikuchi Daisuke, Hoteya Shu, Kajiyama Yoshiaki, Kaise Mitsuru
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
Department of Upper Gastrointestinal Surgery, Juntendo University, Tokyo, Japan.
Endosc Int Open. 2017 Aug;5(8):E736-E741. doi: 10.1055/s-0043-112493. Epub 2017 Aug 7.
Cervical esophageal cancer (CEC) is a less common form of cancer and often locally advanced at the time of diagnosis; thus, survival rates for patients with CEC remain poor. However, no reports exist on results of endoscopic submucosal dissection (ESD) for superficial cancer at the cervical esophagus. The aim of this retrospective study was to elucidate the clinicopathological features and clinical outcomes of ESD for superficial CEC.
ESD was performed on 891 lesions (in 662 patients) for superficial esophageal cancer from January 2008 to December 2015. Of these, 45 lesions (45 patients) were enrolled in the case group (CEC), and 405 lesions (375 patients) were enrolled in the control group (superficial cancer in the middle thoracic esophagus). The safety of ESD, including R0 resection rate and adverse events, and the efficacy, such as the local recurrence rate and overall survival rate, were evaluated.
The R0 resection rate was 91.1 % in the case group and 96 % in the control group. The rate of esophageal stricture was significantly higher in the case group (20 %) than in the control group (6.6 %). There was no local recurrence, and the 3-year survival rate was 88.4 % in the case group and 96.7 % in the control group.
ESD for superficial cancer in the cervical esophagus was achieved safely, and successful local control was also confirmed. However, the esophageal stricture after ESD was more frequent.
颈段食管癌(CEC)是一种较罕见的癌症形式,在诊断时通常已局部进展;因此,CEC患者的生存率仍然很低。然而,尚无关于颈段食管浅表癌内镜黏膜下剥离术(ESD)结果的报告。本回顾性研究的目的是阐明ESD治疗浅表性CEC的临床病理特征和临床结局。
2008年1月至2015年12月期间,对891例(662例患者)浅表性食管癌病变进行了ESD。其中,45例病变(45例患者)纳入病例组(CEC),405例病变(375例患者)纳入对照组(胸段中段食管浅表癌)。评估了ESD的安全性,包括R0切除率和不良事件,以及疗效,如局部复发率和总生存率。
病例组的R0切除率为91.1%,对照组为96%。病例组食管狭窄发生率(20%)显著高于对照组(6.6%)。无局部复发,病例组3年生存率为88.4%,对照组为96.7%。
ESD治疗颈段食管浅表癌安全可行,局部控制效果良好。然而,ESD术后食管狭窄更为常见。