Doumbe-Mandengue Paul, Beuvon Frédéric, Belle Arthur, Dermine Solène, Palmieri Lola-Jade, Abou Ali Einas, Hallit Rachel, Leconte Mahaut, Dohan Anthony, Bibault Jean-Emmanuel, Terris Benoit, Chaussade Stanislas, Coriat Romain, Barret Maximilien
Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
Department of Pathology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Clin Res Hepatol Gastroenterol. 2021 May;45(3):101700. doi: 10.1016/j.clinre.2021.101700. Epub 2021 Apr 20.
Adenocarcinomas of the esophagus and of the gastric cardia are regarded as a same clinical entity in oncology. For endoscopic resection however, endoscopic mucosal resection is recommended for esophageal adenocarcinoma, while endoscopic submucosal dissection (ESD) is advocated for gastric adenocarcinomas. Our aim was to compare the outcomes of ESD in both types of esophagogastric junction adenocarcinomas.
Between March 2015 and December 2019, we included all patients who underwent an ESD for early adenocarcinoma of the esophagogastric junction at a French tertiary referral center. Esophageal and gastric cardia adenocarcinomas were compared in terms of clinical, procedural and histological outcomes.
57 esophageal and 19 gastric cardia adenocarcinomas were included in the analysis, for a total of 76 patients. The median (IQR) size of the resections was 40 (40-57.5) and 50 (35-55)mm, p=0.96, respectively. En bloc resection was achieved in 100% and 89% for adenocarcinomas of the esophagus and the gastric cardia, p=0.06. Late adverse events occurred in 14% and 5.3%, respectively, p=0.44, with no severe adverse event. Curative resection rates were 67% and 63% for adenocarcinomas of the esophagus and the gastric cardia, respectively, p=0.89.
ESD is a safe treatment for T1 adenocarcinomas of the esophagogastric junction, curative in two thirds of the patients, in tumors arising from the esophagus or from the stomach. ESD should be considered for the routine resection of esophageal adenocarcinomas.
在肿瘤学中，食管腺癌和贲门腺癌被视为同一临床实体。然而，对于内镜切除，食管腺癌建议采用内镜黏膜切除术，而胃腺癌则提倡采用内镜黏膜下剥离术（ESD）。我们的目的是比较两种类型的食管胃交界腺癌ESD的治疗效果。
2015年3月至2019年12月期间，我们纳入了在法国一家三级转诊中心接受ESD治疗食管胃交界早期腺癌的所有患者。比较了食管和贲门腺癌的临床、手术及组织学结果。
分析纳入了57例食管腺癌和19例贲门腺癌患者，共76例。切除标本的中位（四分位间距）大小分别为40（40 - 57.5）和50（35 - 55）mm，p = 0.96。食管腺癌和贲门腺癌的整块切除率分别为100%和89%，p = 0.06。迟发性不良事件发生率分别为14%和5.3%，p = 0.44，均无严重不良事件。食管腺癌和贲门腺癌的根治性切除率分别为67%和63%，p = 0.89。
ESD是治疗食管胃交界T1期腺癌的一种安全方法，对于起源于食管或胃的肿瘤，三分之二的患者可实现根治。ESD应被视为食管腺癌常规切除的方法。
