Safety and curative ability of endoscopic submucosal dissection for superficial esophageal cancers at least 50 mm in diameter

Takeshi Yamashina, Ryu Ishihara, Noriya Uedo, Kengo Nagai, Fumi Matsui, Natsuko Kawada, Takashi Oota, Hiromitsu Kanzaki, Masao Hanafusa, Sachiko Yamamoto, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Hiroyasu Iishi

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22 Citations (Scopus)

Abstract

Background and Aim: Limited data are available regarding the use of endoscopic submucosal dissection (ESD) for superficial esophageal cancers ≥50 mm in diameter. The aim of the present study was to investigate the safety and success of ESD for superficial esophageal cancers ≥50 mm. Methods: A total of 39 patients with superficial esophageal squamous cell carcinoma ≥50 mm were treated with ESD at Osaka Medical Center for Cancer and Cardiovascular Diseases between January 2004 and April 2011, and were analyzed in a retrospective study. Results: En bloc resection was achieved in all patients. One mediastinal emphysema without perforation occurred during the procedure. Stricture developed in 11 of 39 patients, requiring a median of five endoscopic balloon dilatation procedures. Thirty-three clinical epithelial or lamina propria mucosal cancers were treated by ESD with curative intent, of which invasion into the muscularis mucosa or deeper was detected in seven and lymphovascular involvement in three. The en bloc resection rate was 100% with a tumor-free margin achieved in 92% of lesions. The curative resection and complication rates during ESD were 70% and 2.5%, respectively. Conclusion: ESD achieved a high en bloc resection rate of 92% with a tumor-free margin. Curative resection rate of ESD in patients with clinical epithelial or lamina propria mucosal cancers was not low at 70%. However, the risk of stricture must be taken into account when considering the use of ESD in lesions ≥50 mm.

Original languageEnglish
Pages (from-to)220-225
Number of pages6
JournalDigestive Endoscopy
Volume24
Issue number4
DOIs
Publication statusPublished - Jul 1 2012
Externally publishedYes

Keywords

  • endoscopic submucosal dissection
  • esophageal stricture
  • steroid injection
  • superficial esophageal cancer

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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  • Cite this

    Yamashina, T., Ishihara, R., Uedo, N., Nagai, K., Matsui, F., Kawada, N., Oota, T., Kanzaki, H., Hanafusa, M., Yamamoto, S., Hanaoka, N., Takeuchi, Y., Higashino, K., & Iishi, H. (2012). Safety and curative ability of endoscopic submucosal dissection for superficial esophageal cancers at least 50 mm in diameter. Digestive Endoscopy, 24(4), 220-225. https://doi.org/10.1111/j.1443-1661.2011.01215.x