Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People's Republic of China.
Surg Endosc. 2024 Nov;38(11):6637-6642. doi: 10.1007/s00464-024-11259-y. Epub 2024 Sep 18.
Esophageal cancer poses a significant health burden globally. Endoscopic treatment has emerged as a viable option for patient ineligible for surgery or experiencing disease recurrence post-radiotherapy.
Patients visiting the Department of Endoscopy at the Cancer Hospital of China Academy of Medical Sciences between March 2009 and March 2024 were retrospectively analyzed. Inclusion criteria encompassed patients with histologically confirmed esophageal cancer who had not undergone surgery, but received radiotherapy or CRT, and subsequently opted for endoscopic treatment. Data on demographics, treatment modalities, recurrence patterns, histopathological characteristics, and outcomes were collected. Statistical analysis was conducted using SPSS 27.0, employing Kolmogorov-Smirnov tests for data normality assessment.
Out of 25 included patients, the mean age was 60.29 years, with a predominance of males (88%). Most patients (64%) received chemoradiotherapy (CRT), while the rest underwent radiotherapy alone. The median follow-up duration was 50.92 months, with a median recurrence time of 38.92 months. Majority (56%) presented with a solitary lesion and 76% had negative margins. Histopathological analysis revealed various stages of cancer, with the most common being high-grade squamous epithelial neoplasia (64%). Survival analysis indicated a 72% overall survival rate, with 16% surviving beyond 5-year post-treatment. Approximately, 20% succumbed during the study, primarily due to non-esophageal causes (16%).
Endoscopic treatment shows promise as a therapeutic option for selected esophageal cancer patients, offering favorable outcomes in terms of survival and disease control. Further prospective studies are warranted to validate these findings and optimize patient selection criteria for endoscopic interventions in esophageal cancer management.
食管癌在全球范围内造成了重大的健康负担。对于不符合手术条件或在放射治疗后出现疾病复发的患者,内镜治疗已成为一种可行的选择。
回顾性分析了 2009 年 3 月至 2024 年 3 月期间在中国医学科学院肿瘤医院内镜科就诊的患者。纳入标准包括未经手术但接受过放射治疗或放化疗且随后选择内镜治疗的组织学证实的食管癌患者。收集患者的人口统计学、治疗方式、复发模式、组织病理学特征和结局等数据。采用 SPSS 27.0 进行统计分析,采用 Kolmogorov-Smirnov 检验评估数据正态性。
25 例患者中,平均年龄为 60.29 岁,男性占比 88%。大多数患者(64%)接受了放化疗(CRT),其余患者仅接受了放射治疗。中位随访时间为 50.92 个月,中位复发时间为 38.92 个月。大多数患者(56%)表现为单发病变,76%的边缘为阴性。组织病理学分析显示存在不同阶段的癌症,最常见的是高级别鳞状上皮内瘤变(64%)。生存分析显示总生存率为 72%,16%的患者在治疗后 5 年以上仍存活。约 20%的患者在研究期间死亡,主要是非食管原因(16%)。
内镜治疗为选定的食管癌患者提供了一种有前途的治疗选择,在生存和疾病控制方面显示出良好的结果。需要进一步的前瞻性研究来验证这些发现,并优化内镜干预在食管癌管理中的患者选择标准。