Lian Jingjing, Ji Yingjie, Chen Tao, Wang Guoxiang, Wang Mizhu, Li Shengxi, Cao Jia, Shen Li, Lu Wei, Xu Meidong
Endoscopy Center, Department of Gastroenterology, Shanghai East Hospital, Tongji University, Shanghai, China.
Department of Gastroenterology, Taizhou Municipal Hospital, Taizhou, Zhejiang, China.
Therap Adv Gastroenterol. 2024 Jun 5;17:17562848241255304. doi: 10.1177/17562848241255304. eCollection 2024.
Esophageal gastrointestinal stromal tumors (E-GISTs) are highly uncommon and have not been thoroughly examined.
The objective of this multi-center study was to assess the viability of endoscopic resection (ER) in the treatment of E-GISTs and to explore its clinical implications.
This was a multi-center retrospective study. Consecutive patients referred to the four participating centers.
E-GISTs among the consecutive subepithelial tumors (SETs) treated by ER methods were enrolled from April 2019 to August 2022. Clinicopathological, endoscopic, and follow-up data were collected and analyzed.
A total of 23 patients with E-GISTs were included for analysis, accounting for 1.9% of all the esophageal SETs (1243 patients). The average size of the tumor lesions was 2.3 cm (range 1.0-4.0 cm). We observed that tumors larger than 2.0 cm were more likely to grow deeper, with a statistically significant difference ( < 0.001). resection was achieved in all 23 patients. The mean operation time was 53.6 min (range 25-111 min). One patient experienced significant intraoperative bleeding, which was promptly managed endoscopically without necessitating surgery. The average hospital stay was 4.5 days (range 3-8 days). The overall median follow-up period was 31 months (range 13-47 months). No tumor recurrence, residual tumor, distal metastasis, or death was observed during the follow-up period.
Based on our limited data, our study indicates that ER may be a feasible and effective option for treating esophageal GISTs measuring 4 cm or less. We suggest submucosal tunnel endoscopic resection as the preferred approach, as all E-GISTs in our study were situated in the muscularis propria layer. Additionally, tumors larger than 2 cm were more prone to deeper growth or extraluminal extension.
食管胃肠道间质瘤（E-GISTs）极为罕见，尚未得到充分研究。
本多中心研究旨在评估内镜切除术（ER）治疗E-GISTs的可行性，并探讨其临床意义。
这是一项多中心回顾性研究。连续纳入四个参与中心的患者。
纳入2019年4月至2022年8月期间采用ER方法治疗的连续性上皮下肿瘤（SETs）中的E-GISTs。收集并分析临床病理、内镜及随访数据。
共纳入23例E-GISTs患者进行分析，占所有食管SETs患者（1243例）的1.9%。肿瘤病变的平均大小为2.3厘米（范围1.0 - 4.0厘米）。我们观察到，大于2.0厘米的肿瘤更有可能生长至更深层，差异具有统计学意义（<0.001）。23例患者均成功完成切除。平均手术时间为53.6分钟（范围25 - 111分钟）。1例患者术中出现大量出血，经内镜及时处理，无需手术。平均住院时间为4.5天（范围3 - 8天）。总体中位随访期为31个月（范围13 - 47个月）。随访期间未观察到肿瘤复发、残留肿瘤、远处转移或死亡。
基于我们有限的数据，本研究表明ER可能是治疗直径4厘米及以下食管GISTs的一种可行且有效的选择。由于本研究中的所有E-GISTs均位于固有肌层，我们建议将黏膜下隧道内镜切除术作为首选方法。此外，大于2厘米的肿瘤更容易向深层生长或腔外扩展。
