Min Yang Won
Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2018 Mar 25;71(3):116-123. doi: 10.4166/kjg.2018.71.3.116.
Esophageal cancer incidence rate per 100,000 is 4.7 in 2013, which accounts for 1.1% of the total cancer incidence in Korea. Superficial esophageal squamous cell carcinoma is frequently detected in persons undergoing upper endoscopy for gastrointestinal symptoms or for gastric cancer screening. Esophagectomy with lymph node dissection is the standard treatment for esophageal cancer. However, given the considerable morbidity and mortality of esophagectomy, endoscopic resection has become the standard of care for most cases of superficial esophageal squamous cell carcinoma without metastasis. In addition, endoscopic submucosal dissection has increased the cure rate, even when the tumor is large, compared to endoscopic mucosal resection. Thus, endoscopic submucosal dissection is the treatment of choice for superficial esophageal squamous cell carcinoma with a negligible risk of lymph node metastasis. Endoscopic resection is usually associated with a low risk of morbidity and no mortality, and has also shown favorable long-term outcomes. However, the long-term risk of metastasis remains after endoscopic resection, which varies according to the characteristics of tumor. This review describes the indication and outcomes of endoscopic resection, complications of endoscopic resection, and management after treatment.
2013年，每10万人中食管癌发病率为4.7，占韩国癌症总发病率的1.1%。浅表性食管鳞状细胞癌常在因胃肠道症状接受上消化道内镜检查或胃癌筛查的人群中被发现。食管癌切除加淋巴结清扫是食管癌的标准治疗方法。然而，鉴于食管癌切除术存在相当高的发病率和死亡率，内镜下切除已成为大多数无转移的浅表性食管鳞状细胞癌病例的标准治疗手段。此外，与内镜下黏膜切除术相比，即使肿瘤较大，内镜下黏膜下剥离术也提高了治愈率。因此，内镜下黏膜下剥离术是淋巴结转移风险可忽略不计的浅表性食管鳞状细胞癌的首选治疗方法。内镜下切除通常发病率低且无死亡率，并且长期预后良好。然而，内镜下切除后仍存在转移的长期风险，其根据肿瘤特征而有所不同。本综述描述了内镜下切除的适应证和结果、内镜下切除的并发症以及治疗后的管理。
