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[浅表性食管鳞状细胞癌的内镜治疗及切除后处理策略]

[Strategies for the Endoscopic Management and Post-Resection Treatment of Superficial Esophageal Squamous Cell Carcinoma].

作者信息

Choi Hyun Ho

出版信息

Korean J Helicobacter Up Gastrointest Res. 2024 Mar;24(1):40-44. doi: 10.7704/kjhugr.2024.0009. Epub 2024 Mar 8.

DOI:10.7704/kjhugr.2024.0009
PMID:40503287
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12021530/
Abstract

Endoscopic resection (ER) is preferred for treating superficial esophageal squamous cell carcinoma (SESCC) that has a low risk of lymph node metastasis; the preference is due to the technique's minimal invasiveness and having outcomes comparable to those of surgical resection, in suitable cases. Determining the appropriateness of ER requires a multidisciplinary review involving a pathological examination of the tumor's depth, size, and lymphovascular invasion following resection of a specimen. According to the Korean guidelines, no additional treatment is necessary after a complete en bloc resection of SESCC that lacks submucosal invasion and lymphovascular invasion. In cases of non-curative resection for tumors that exhibit submucosal invasion, lymphovascular invasion, or positive margins, additional treatment (e.g., esophagectomy or chemoradiotherapy) is recommended. Due to the uncertainty regarding which treatment is more effective, tailored therapy that is based on patient factors and tumor characteristics is needed to maximize patient long-term survival and improve quality of life.

摘要

对于淋巴结转移风险较低的浅表性食管鳞状细胞癌(SESCC),内镜切除术(ER)是首选治疗方法;之所以优先选择该技术,是因为在合适的病例中,它具有微创性且治疗效果与手术切除相当。确定ER的适用性需要多学科评估,包括对切除标本进行肿瘤深度、大小及淋巴管浸润的病理检查。根据韩国的指南,对于未发生黏膜下浸润和淋巴管浸润的SESCC,完整整块切除术后无需额外治疗。对于存在黏膜下浸润、淋巴管浸润或切缘阳性的肿瘤,若切除不彻底,则建议进行额外治疗(如食管切除术或放化疗)。由于哪种治疗方法更有效尚不确定,因此需要根据患者因素和肿瘤特征制定个性化治疗方案,以最大限度地提高患者长期生存率并改善生活质量。

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本文引用的文献

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Prediction of lymph node metastasis in superficial esophageal squamous cell carcinoma in Asia: a systematic review and meta-analysis.亚洲表浅性食管鳞癌淋巴结转移预测:系统回顾和荟萃分析。
Dis Esophagus. 2020 Dec 7;33(12). doi: 10.1093/dote/doaa032.
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Dig Endosc. 2020 May;32(4):452-493. doi: 10.1111/den.13654.
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Crit Rev Oncol Hematol. 2020 Mar;147:102883. doi: 10.1016/j.critrevonc.2020.102883. Epub 2020 Jan 25.