Curative Management After Endoscopic Resection for Esophageal Squamous Cell Carcinoma Invading Muscularis Mucosa or Shallow Submucosal Layer-Multicenter Real-World Survey in Japan.

Autor:	Katada C; Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.; Department of Real World Data Research and Development, Graduate School of Medicine, Kyoto University, Kyoto, Japan., Yokoyama T; Department of Health Promotion, National Institute of Public Health, Wako, Japan., Hirasawa D; Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan., Iizuka T; Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan., Kikuchi D; Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan., Yano T; Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan., Hombu T; Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan., Yoshio T; Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan., Yoshimizu S; Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan., Ono H; Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan., Yabuuchi Y; Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan., Terai S; Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan., Hashimoto S; Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan., Takahashi K; Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan., Tanaka S; Endoscopy and Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan., Urabe Y; Gastrointestinal Endoscopy and Medicine, Hiroshima University Hospital, Hiroshima, Japan., Arima M; Department of Gastroenterology, Saitama Cancer Center, Saitama, Japan., Tanabe S; Department of Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Japan., Wada T; Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan., Furue Y; Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan., Oyama T; Department of Endoscopy, Saku Central Hospital Advanced Care Center, Nagano, Japan., Takahashi A; Department of Endoscopy, Saku Central Hospital Advanced Care Center, Nagano, Japan., Sakamoto Y; Kitasato Clinical Research Center, Kitasato University School of Medicine, Sagamihara, Japan., Muto M; Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Jazyk:	angličtina
Zdroj:	The American journal of gastroenterology [Am J Gastroenterol] 2023 Jul 01; Vol. 118 (7), pp. 1175-1183. Date of Electronic Publication: 2022 Dec 24.
DOI:	10.14309/ajg.0000000000002106
Abstrakt:	Introduction: Curative management after endoscopic resection (ER) for esophageal squamous cell carcinoma (ESCC), which invades the muscularis mucosa (pMM-ESCC) or shallow submucosal layer (pSM1-ESCC), has been controversial. Methods: We identified patients with pMM-ESCC and pSM1-ESCC treated by ER. Outcomes were the predictive factors for regional lymph node and distant recurrence, and survival data were based on the depth of invasion, lymphovascular invasion (LVI), and additional treatment immediately after ER. Results: A total of 992 patients with pMM-ESCC (n = 749) and pSM1-ESCC (n = 243) were registered. According to the multivariate Cox proportional hazards analysis, pSM1-ESCC (hazard ratio = 1.88, 95% confidence interval 1.15-3.07, P = 0.012) and LVI (hazard ratio = 6.92, 95% confidence interval 4.09-11.7, P < 0.0001) were associated with a risk of regional lymph node and distant recurrence. In the median follow-up period of 58.6 months (range 1-233), among patients with risk factors (pMM-ESCC with LVI or pSM1-ESCC), the 5-year overall survival rates, relapse-free survival rates, and cause-specific survival rates of patients with additional treatment were significantly better than those of patients without additional treatment; 85.4% vs 61.5% ( P < 0.0001), 80.5% vs 53.3% ( P < 0.0001), and 98.5% vs 93.1% ( P = 0.004), respectively. There was no difference in survival rate between the chemoradiotherapy and surgery groups. Discussion: pSM1 and LVI were risk factors for metastasis after ER for ESCC. To improve the survival, additional treatment immediately after ER, such as chemoradiotherapy or surgery, is effective in patients with these risk factors. (Copyright © 2023 by The American College of Gastroenterology.)
Databáze:	MEDLINE
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