Long‑term prognosis and comprehensive endoscopic treatment strategy for esophageal cancer, including salvage endoscopic treatment after chemoradiation therapy

Shiota,Junya; Yamaguchi,Naoyuki; Isomoto,Hajime; Taniguchi,Yasuhiro; Matsushima,Kayoko; Akazawa,Yuko; Nakao,Kazuhiko

doi:10.3892/etm.2023.11820

Long‑term prognosis and comprehensive endoscopic treatment strategy for esophageal cancer, including salvage endoscopic treatment after chemoradiation therapy

Authors:
- Junya Shiota
- Naoyuki Yamaguchi
- Hajime Isomoto
- Yasuhiro Taniguchi
- Kayoko Matsushima
- Yuko Akazawa
- Kazuhiko Nakao
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Affiliations: Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852‑8523, Japan, Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki 852‑8501, Japan, Department of Multidisciplinary Internal Medicine, Division of Gastroenterology and Nephrology, Tottori University Faculty of Medicine, Yonago, Tottori 683‑8504, Japan
Published online on: February 1, 2023 https://doi.org/10.3892/etm.2023.11820
Article Number: 121
Copyright: © Shiota et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Endoscopic submucosal dissection (ESD) is the first treatment option for superficial squamous cell carcinoma of the esophagus (SSCE). Salvage endoscopic treatment for recurrent advanced esophageal cancer after chemoradiotherapy (CRT) has been reported. However, there are few reports on long‑term prognosis after salvage endoscopic treatment in Japan. The present study investigated long‑term treatment results after conventional ESD for SSCE and after salvage endoscopic treatment for locally recurrent lesions after CRT. Outcomes of esophageal ESD were retrospectively investigated at Nagasaki University Hospital and long‑term prognosis after salvage endoscopic treatment for locally recurrence lesions after CRT was examined. The en‑bloc curative resection rate was 89.5% (606/676) for conventional ESD. The 5‑year cause‑specific survival rate (CSS) was 98.5%. A total of 77 patients underwent salvage endoscopic treatment [ESD or photodynamic therapy (PDT)] for locally recurrent lesions after CRT. The 3‑year CSS was 81.3 and 77.1% for salvage ESD and salvage PDT, respectively. SSCE management using ESD yielded high en‑bloc curative resection and survival rates. Overall, establishing salvage endoscopic treatment made long‑term control of the underlying disease possible, while also maintaining the quality of life for patients with recurrent advanced esophageal cancer deeper than patients with T1b who underwent CRT and patients with recurrence after additional CRT following ESD.

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