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Carola Fleischmann 1 Article
Endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma: long-term follow-up in a Western center
Andreas Probst, Alanna Ebigbo, Stefan Eser, Carola Fleischmann, Tina Schaller, Bruno Märkl, Stefan Schiele, Bernd Geissler, Gernot Müller, Helmut Messmann
Clin Endosc 2023;56(1):55-64.   Published online January 13, 2023
DOI: https://doi.org/10.5946/ce.2022.093
AbstractAbstract PDFPubReaderePub
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.

Citations

Citations to this article as recorded by  
  • Endoscopic submucosal dissection for early esophageal squamous cell carcinoma: long-term results from a Western cohort
    Ilse N. Beaufort, Charlotte N. Frederiks, Anouk Overwater, Lodewijk A.A. Brosens, Arjun D. Koch, Roos E. Pouw, Jacques J.G.H.M. Bergman, Bas L.A.M. Weusten
    Endoscopy.2024; 56(05): 325.     CrossRef
  • Endoscopic Submucosal Dissection for Esophageal Cancer: Current and Future
    Yuki Okubo, Ryu Ishihara
    Life.2023; 13(4): 892.     CrossRef
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