内镜粘膜切除术与内镜粘膜下剥离术在巴雷特食管中成功根除肿瘤后的复发情况:回顾性比较。

IF 11.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Endoscopy Pub Date : 2025-01-01 Epub Date: 2024-09-03 DOI:10.1055/a-2382-5891
Yusuke Fujiyoshi, Kareem Khalaf, Daniel Tham, Mary Raina Angeli Fujiyoshi, Natalia C Calo, Jeffrey D Mosko, Gary R May, Christopher W Teshima
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引用次数: 0

摘要

背景:内镜粘膜切除术(EMR)和内镜粘膜下剥离术(ESD)是治疗巴雷特瘤的有效方法。然而,人们对这些技术的复发率知之甚少。我们比较了 EMR 和 ESD 术后的长期肿瘤复发率:本研究纳入了2019年7月至2023年12月期间在加拿大一家三级转诊中心接受治疗的巴雷特肿瘤(高级别发育不良/腺癌)患者。结果为首次随访时肿瘤残留、肿瘤完全缓解(CRN)和CRN后肿瘤复发:共纳入 157 例患者(87 例 EMR,70 例 ESD)。与EMR相比,ESD组患者的病灶更大(中位2 cm vs. 3 cm,PP = 0.07),粘膜下浸润更深(T1a:71.6% vs. 75.8%;T1b-SM1:25.7% vs. 6.1%;T1b≥SM2:2.7% vs. 18.2%;PPConclusions:与ESD相比,EMR术后CRN的肿瘤复发率明显更高,这表明ESD在预防巴雷特食管肿瘤复发方面可能优于EMR。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Recurrence following successful eradication of neoplasia with endoscopic mucosal resection compared with endoscopic submucosal dissection in Barrett's esophagus: a retrospective comparison.

Background: Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are effective treatments for Barrett's neoplasia. However, little is known about recurrence rates following these techniques. We compared long-term neoplasia recurrence rates following EMR and ESD.

Methods: This study included patients with Barrett's neoplasia (high grade dysplasia/adenocarcinoma) treated between July 2019 and December 2023 at a tertiary referral center in Canada. Outcomes were residual neoplasia at first follow-up, complete remission of neoplasia (CRN), and neoplasia recurrence following CRN.

Results: 157 patients were included (87 EMR, 70 ESD). Compared with EMR, the ESD group had larger lesions (median 2 vs. 3 cm, P<0.05), more adenocarcinoma (85.1% vs. 94.3%, P = 0.07), and deeper submucosal invasion (T1a: 71.6% vs. 75.8%; T1b-SM1: 25.7% vs. 6.1%; T1b≥SM2: 2.7% vs. 18.2%; P<0.05). Among 124 patients with follow-up (71 EMR, 53 ESD), 84.9% of ESD-treated patients had curative resections (i.e. R0 resection with low risk for lymph node metastasis), whereas 94.4% of EMR-treated patients had deep margin R0 resection of low risk lesions. At first follow-up, residual neoplasia (14.1% vs. 11.3%) and CRN (97.2% vs. 100%) were similar in the EMR and ESD groups, but neoplasia recurrence following CRN was significantly higher with EMR (13% vs. 1.9%, P<0.05), with cumulative probability of recurrence at 3 years of 18.3% vs. 4.2%, respectively.

Conclusions: Neoplasia recurrence following CRN was significantly higher following EMR compared with ESD, suggesting that ESD may be superior to EMR in preventing neoplasia recurrence in Barrett's esophagus.

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来源期刊
Endoscopy
Endoscopy 医学-外科
CiteScore
5.80
自引率
11.80%
发文量
1401
审稿时长
2 months
期刊介绍: Endoscopy is a leading journal covering the latest technologies and global advancements in gastrointestinal endoscopy. With guidance from an international editorial board, it delivers high-quality content catering to the needs of endoscopists, surgeons, clinicians, and researchers worldwide. Publishing 12 issues each year, Endoscopy offers top-quality review articles, original contributions, prospective studies, surveys of diagnostic and therapeutic advances, and comprehensive coverage of key national and international meetings. Additionally, articles often include supplementary online video content.
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