Combination of endoscopic submucosal dissection and chemoradiation therapy for superficial esophageal squamous cell carcinoma with submucosal invasion

Mochizuki,Yosuke; Saito,Yasuharu; Tsujikawa,Tomoyuki; Fujiyama,Yoshihide; Andoh,Akira

doi:10.3892/etm.2011.319

Combination of endoscopic submucosal dissection and chemoradiation therapy for superficial esophageal squamous cell carcinoma with submucosal invasion

Authors:
- Yosuke Mochizuki
- Yasuharu Saito
- Tomoyuki Tsujikawa
- Yoshihide Fujiyama
- Akira Andoh
View Affiliations

Affiliations: Division of Digestive Endoscopy, Shiga University of Medical Science, Seta-Tukinowa, Otsu 520-2192, Japan, Department of Medicine, Shiga University of Medical Science, Seta-Tukinowa, Otsu 520-2192, Japan, Division of Mucosal Immunology, Shiga University of Medical Science, Seta-Tukinowa, Otsu 520-2192, Japan
Published online on: July 14, 2011 https://doi.org/10.3892/etm.2011.319
Pages: 1065-1068

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The efficacy, safety and clinical outcomes of a combination of endoscopic submucosal dissection (ESD) with subsequent chemoradiation therapy (CRT) for superficial esophageal squamous cell carcinomas (superficial ESCC) remain unclear. We assessed the outcome of the combination of ESD plus CRT for superficial ESCC. Fourteen patients with superficial ESCC invading into the muscularis mucosa or submucosa were treated with ESD plus CRT from 2004 to 2010. En bloc resection of the lesion was successfully performed in all patients. The mean diameter of the lesions was 25 mm (range 10-55). The distribution of the depth of tumor invasion was to the muscularis mucosa in 8 patients, to the upper submucosal third (sm1) in 4 patients and to the middle submucosal third (sm2) in 2 patients. The laterally resected margins and vascular invasion were cancer-negative in all patients, but lymph node involvement was detected in 2 patients. The mean follow-up period after CRT was 45 months (range 19-70). No patients died of esophageal cancer. Recurrence or metastasis of the esophageal cancer was not observed in any of the patients. The combination of ESD plus CRT is effective for superficial ESCC.

View Figures

View References

1	Katada C, Muto M, Momma K, et al: Clinical outcome after endoscopic mucosal resection for esophageal squamous cell carcinoma invading the muscularis mucosae – a multicenter retrospective cohort study. Endoscopy. 39:779–783. 2007.
2	Teoh AY, Chiu PW, Yu Ngo DK, Wong SK, Lau JY and Ng EK: Outcomes of endoscopic submucosal dissection versus endoscopic mucosal resection in management of superficial squamous esophageal neoplasms outside Japan. J Clin Gastroenterol. 44:e190–e194. 2010.
3	Repici A, Hassan C, Carlino A, et al: Endoscopic submucosal dissection in patients with early esophageal squamous cell carcinoma: results from a prospective Western series. Gastrointest Endosc. 71:715–721. 2010. View Article : Google Scholar : PubMed/NCBI
4	Fujishiro M, Yahagi N, Kakushima N, et al: Endoscopic submucosal dissection of esophageal squamous cell neoplasms. Clin Gastroenterol Hepatol. 4:688–694. 2006. View Article : Google Scholar : PubMed/NCBI
5	Gockel I, Sgourakis G and Lang H: Superficial esophageal cancer: endoscopic resection or radical surgery? Expert Rev Anticancer Ther. 10:1345–1347. 2010. View Article : Google Scholar : PubMed/NCBI
6	Ishihara R, Iishi H, Uedo N, et al: Comparison of EMR and endoscopic submucosal dissection for en bloc resection of early esophageal cancers in Japan. Gastrointest Endosc. 68:1066–1072. 2008. View Article : Google Scholar : PubMed/NCBI
7	Eguchi T, Nakanishi Y, Shimoda T, et al: Histopathological criteria for additional treatment after endoscopic mucosal resection for esophageal cancer: analysis of 464 surgically resected cases. Mod Pathol. 19:475–480. 2006. View Article : Google Scholar
8	Yoshida T, Inoue H, Usui S, Satodate H, Fukami N and Kudo SE: Narrow-band imaging system with magnifying endoscopy for superficial esophageal lesions. Gastrointest Endosc. 59:288–295. 2004. View Article : Google Scholar : PubMed/NCBI
9	Ishihara R, Iishi H, Takeuchi Y, et al: Local recurrence of large squamous-cell carcinoma of the esophagus after endoscopic resection. Gastrointest Endosc. 67:799–804. 2008. View Article : Google Scholar : PubMed/NCBI
10	Esaki M, Matsumoto T, Hirakawa K, et al: Risk factors for local recurrence of superficial esophageal cancer after treatment by endoscopic mucosal resection. Endoscopy. 39:41–45. 2007. View Article : Google Scholar : PubMed/NCBI
11	Oyama T, Tomori A, Hotta K, et al: Endoscopic submucosal dissection of early esophageal cancer. Clin Gastroenterol Hepatol. 3:S67–S70. 2005. View Article : Google Scholar : PubMed/NCBI
12	Takashi H, Arimura Y, Masao H, et al: Endoscopic submucosal dissection is superior to conventional endoscopic resection as a curative treatment for early squamous cell carcinoma of the esophagus. Gastrointest Endosc. 72:255–264. 2010. View Article : Google Scholar
13	Bidoli P, Bajetta E, Stani SC, et al: Ten-year survival with chemotherapy and radiotherapy in patients with squamous cell carcinoma of the esophagus. Cancer. 94:352–361. 2002.PubMed/NCBI
14	Murakami M, Kuroda Y, Nakajima T, et al: Comparison between chemoradiation protocol intended for organ preservation and conventional surgery for clinical T1–T2 esophageal carcinoma. Int J Radiat Oncol Biol Phys. 45:277–284. 1999.PubMed/NCBI
15	Okawa T, Tanaka M, Kita-Okawa M, et al: Superficial esophageal cancer: multicenter analysis of results of definitive radiation therapy in Japan. Radiology. 196:271–274. 1995. View Article : Google Scholar : PubMed/NCBI
16	Shimizu Y, Kato M, Yamamoto J, et al: EMR combined with chemoradiotherapy: a novel treatment for superficial esophageal squamous-cell carcinoma. Gastrointest Endosc. 59:199–204. 2004. View Article : Google Scholar : PubMed/NCBI