Digestion. 2018;97(4):316-323. doi: 10.1159/000486197. Epub 2018 Mar 14.
In recent years, effective outcomes of endoscopic submucosal dissection (ESD) for esophagogastric junction cancer including short-segment Barrett's esophagus (SSBE) cancer have been reported. However, the efficacy of ESD for long-segment Barrett's esophagus (LSBE) cancer is unknown.
To clarify the treatment outcomes of ESD for LSBE cancer versus SSBE cancer.
A total of 86 patients with 91 superficial Barrett's esophageal adenocarcinomas who underwent ESD were enrolled; of these, 68 had underlying SSBE and 18 had LSBE. Procedure outcomes and prognosis were compared.
There was no significant difference in age and tumor diameter among patients. The only complication observed was stricture, but it was not significant (2 vs. 9%). No significant difference was observed in the negative horizontal margin rates (94.1 vs. 95.7%), R0 resection rates (83.8 vs. 82.6%), curative resection rates (72.1 vs. 73.9%), and noncurative factors. Both LSBE and SSBE cancer showed favorable 3-year overall survival rates (95.0 vs. 94.4%) in the median observation period of 28.5 months.
ESD for LSBE cancer achieved procedure outcomes and short-term prognosis comparable to SSBE. ESD has the potential to be an effective therapeutic option for esophageal neoplasms in patients with LSBE.
近年来，内镜黏膜下剥离术（ESD）治疗胃食管结合部癌（包括短节段 Barrett 食管（SSBE）癌）的疗效已得到证实。然而，ESD 治疗长节段 Barrett 食管（LSBE）癌的疗效尚不清楚。
明确 ESD 治疗 LSBE 与 SSBE 癌的疗效。
共纳入 86 例 91 处浅表性 Barrett 食管腺癌患者，均接受 ESD 治疗；其中，68 例为 SSBE，18 例为 LSBE。比较两组患者的治疗结局和预后。
患者的年龄和肿瘤直径无显著差异。唯一观察到的并发症是狭窄，但无统计学意义（2 例 vs. 9 例）。两组患者的阴性水平切缘率（94.1% vs. 95.7%）、R0 切除率（83.8% vs. 82.6%）、根治性切除率（72.1% vs. 73.9%）和非根治性因素无显著差异。在 28.5 个月的中位观察期内，LSBE 和 SSBE 癌患者的 3 年总生存率均为 95.0%（94.4%），均表现出良好的预后。
LSBE 癌的 ESD 治疗可获得与 SSBE 相似的治疗结局和短期预后。ESD 可能成为 LSBE 患者食管肿瘤的有效治疗选择。
