Endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma: long-term follow-up in a Western center
| Autor: | Andreas Probst, Alanna Ebigbo, Stefan Eser, Carola Fleischmann, Tina Schaller, Bruno Märkl, Stefan Schiele, Bernd Geissler, Gernot Müller, Helmut Messmann |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Clinical Endoscopy, Vol 56, Iss 1, Pp 55-64 (2023) |
| Druh dokumentu: | article |
| ISSN: | 2234-2400 2234-2443 |
| DOI: | 10.5946/ce.2022.093 |
| Popis: | Background/Aims Endoscopic submucosal dissection (ESD) has been established as a treatment modality for superficial esophageal squamous cell carcinoma (ESCC). Long-term follow-up data are lacking in Western countries. The aim of this study was to analyze long-term survival in a Western center. Methods Patients undergoing ESD for ESCC were included. The analysis was performed retrospectively using a prospectively collected database. Results R0 resection rate was 96.7% (59/61 lesions in 58 patients). Twenty-seven patients (46.6%) fulfilled the curative resection criteria (M1/M2) (group A), 11 patients (19.0%) had M3 lesions without lymphovascular invasion (LVI) (group B), and 20 patients (34.5%) had lesions with submucosal invasion or LVI (group C). Additional treatment was recommended after non-curative resection. It was not performed in 20/31 patients (64.5%), mainly because of comorbidities (75%). Twenty-nine out of 58 (50.0%) patients died during a mean follow-up of 3.7 years. Death was related to ESCC in 17.2% (5/29) of patients. The disease-specific survival rate after curative resection was 100%. Overall survival rates after 5 years were 61.5%, 63.6% and 28.1% for groups A, B, and C, respectively. The overall survival was significantly worse after non-curative resection (p=0.038). Conclusions Non-curative resection is frequent after ESD for ESCC in Western patients. The long-term prognosis is limited and mainly determined by comorbidity. Early diagnosis and pre-interventional assessments need to be improved. |
| Databáze: | Directory of Open Access Journals |
| Externí odkaz: |
|