Repeat endoscopic submucosal dissection close to the initial endoscopic submucosal dissection scar for superficial esophageal squamous cell carcinoma

IF 2.2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Esophagus Pub Date : 2024-07-27 DOI:10.1007/s10388-024-01074-8

Koki Matsuoka, Tsukasa Ishida, Tetsuya Yoshizaki, Yoshinobu Yamamoto, Mineo Iwatate, Yasuaki Kitamura, Tomoya Sako, Atsushi Ikeda, Takayuki Ose, Fumiaki Kawara, Ryusuke Ariyoshi, Yasushi Sano, Hirofumi Abe, Shinwa Tanaka, Toshitatsu Takao, Yoshinori Morita, Takashi Toyonaga, Toshio Shimokawa, Yuzo Kodama

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引用次数: 0

Abstract

Background

Repeat endoscopic submucosal dissection for metachronous recurrence of esophageal squamous cell carcinoma close to previous endoscopic submucosal dissection scars is challenging. Therefore, this study evaluated the efficacy and safety of repeat endoscopic submucosal dissection for recurrent esophageal squamous cell carcinoma.

Methods

The study included 1680 patients. After propensity score matching, esophageal endoscopic submucosal dissection-related outcomes were compared between the post-endoscopic submucosal dissection scar group (n = 91) and first endoscopic submucosal dissection group (n = 910). The Kaplan–Meier method and log-rank tests were used to compare both groups’ survival and local recurrence curves.

Results

After propensity score matching, the two groups showed no significant difference in en bloc resection rate (97.80% vs. 99.56%, p = 0.096), treatment time (64.75 min vs 61.33 min, p = 0.448), recurrence rate (3.30% vs. 2.20%, p = 0.458), and stricture rate (7.69% vs. 4.07%, p = 0.110). However, the perforation rate was higher in the post-endoscopic submucosal dissection scar group than in the first endoscopic submucosal dissection group (4.40% vs. 1.10%, p = 0.031). The 5-year overall survival rates in the post-endoscopic submucosal dissection scar and first endoscopic submucosal dissection groups were 88.6% and 89.0%, respectively.

Conclusions

Repeated esophageal endoscopic submucosal dissection for recurrent esophageal squamous cell carcinoma yielded satisfactory clinical outcomes and survival rates. Therefore, repeat endoscopic submucosal dissection may effectively treat esophageal squamous cell carcinoma recurrence close to the initial endoscopic submucosal dissection scars.

Abstract Image

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针对浅表食管鳞状细胞癌，在首次内镜黏膜下剥离术疤痕附近再次进行内镜黏膜下剥离术

背景重复内镜黏膜下剥离术治疗食管鳞状细胞癌的近端复发具有挑战性。因此，本研究评估了重复内镜黏膜下剥离术治疗复发性食管鳞状细胞癌的有效性和安全性。经过倾向评分匹配后，比较了内镜粘膜下剥离术后瘢痕组（n = 91）和首次内镜粘膜下剥离术组（n = 910）的食管内镜粘膜下剥离术相关结果。采用卡普兰-梅耶法和对数秩检验比较两组患者的生存率和局部复发率曲线。80% vs. 99.56%，p = 0.096）、治疗时间（64.75 分钟 vs. 61.33 分钟，p = 0.448）、复发率（3.30% vs. 2.20%，p = 0.458）和狭窄率（7.69% vs. 4.07%，p = 0.110）无明显差异。然而，内镜粘膜下剥离术后疤痕组的穿孔率高于首次内镜粘膜下剥离术组（4.40% 对 1.10%，P = 0.031）。内镜下粘膜下剥离术后瘢痕组和首次内镜下粘膜下剥离术后瘢痕组的 5 年总生存率分别为 88.6% 和 89.0%。因此，重复内镜黏膜下剥离术可有效治疗靠近首次内镜黏膜下剥离术疤痕的食管鳞癌复发。

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来源期刊

Esophagus GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.90

自引率

8.30%

发文量

审稿时长

>12 weeks

期刊介绍： Esophagus, the official journal of the Japan Esophageal Society, introduces practitioners and researchers to significant studies in the fields of benign and malignant diseases of the esophagus. The journal welcomes original articles, review articles, and short articles including technical notes ( How I do it ), which will be peer-reviewed by the editorial board. Letters to the editor are also welcome. Special articles on esophageal diseases will be provided by the editorial board, and proceedings of symposia and workshops will be included in special issues for the Annual Congress of the Society.