Outcomes of submucosal (T1b) esophageal adenocarcinomas removed by endoscopic mucosal resection.

Autor:	Ballard DD; Darren D Ballard, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI 53226, United States., Choksi N; Darren D Ballard, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI 53226, United States., Lin J; Darren D Ballard, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI 53226, United States., Choi EY; Darren D Ballard, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI 53226, United States., Elmunzer BJ; Darren D Ballard, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI 53226, United States., Appelman H; Darren D Ballard, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI 53226, United States., Rex DK; Darren D Ballard, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI 53226, United States., Fatima H; Darren D Ballard, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI 53226, United States., Kessler W; Darren D Ballard, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI 53226, United States., DeWitt JM; Darren D Ballard, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI 53226, United States.
Jazyk:	angličtina
Zdroj:	World journal of gastrointestinal endoscopy [World J Gastrointest Endosc] 2016 Dec 16; Vol. 8 (20), pp. 763-769.
DOI:	10.4253/wjge.v8.i20.763
Abstrakt:	Aim: To investigate the outcomes and recurrences of pT1b esophageal adenocarcinoma (EAC) following endoscopic mucosal resection (EMR) and associated treatments. Methods: Patients undergoing EMR with pathologically confirmed T1b EAC at two academic referral centers were retrospectively identified. Patients were divided into 4 groups based on treatment following EMR: Endoscopic therapy alone (group A), endoscopic therapy with either chemotherapy, radiation or both (group B), surgical resection (group C) or no further treatment/lost to follow-up (< 12 mo) (group D). Pathology specimens were reviewed by a central pathologist. Follow-up data was obtained from the academic centers, primary care physicians and/or referring physicians. Univariate analysis was performed to identify factors predicting recurrence of EAC. Results: Fifty-three patients with T1b EAC underwent EMR, of which 32 (60%) had adequate follow-up ≥ 12 mo (median 34 mo, range 12-103). There were 16 patients in group A, 9 in group B, 7 in group C and 21 in group D. Median follow-up in groups A to C was 34 mo (range 12-103). Recurrent EAC developed overall in 9 patients (28%) including 6 (38%) in group A (median: 21 mo, range: 6-73), 1 (11%) in group B (median: 30 mo, range: 30-30) and 2 (29%) in group C (median 21 mo, range: 7-35. Six of 9 recurrences were local; of the 6 recurrences, 5 were treated with endoscopy alone. No predictors of recurrence of EAC were identified. Conclusion: Endoscopic therapy of T1b EAC may be a reasonable strategy for a subset of patients including those either refusing or medically unfit for esophagectomy. Competing Interests: Conflict-of-interest statement: There are no conflicts of interest for any of the authors of this study.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu