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Argon plasma coagulation for local recurrence of squamous cell carcinoma of the esophagus after endoscopic mucosal resection: technique and outcome

Esophagus volume 5, pages 27–32 (2008)Cite this article

Abstract

Background

It is difficult to undergo a second endoscopic mucosal resection (EMR) for local cancer recurrence because ulcer scars caused by the previous EMR are frequently located near the tumor. The main objective of this study was to evaluate whether argon plasma coagulation (APC) is an effective and safe modality for treating early esophageal cancer recurrence untreatable by EMR.

Methods

We reviewed the experience of this clinic in the administration of EMR for the treatment of mucosal esophageal cancer in 249 patients with 276 lesions (142, m1; 98, m2; 36, m3) between December 1989 and March 2005. A local recurrence of the disease after the EMR was detected in 24 cases (9.6%). Seventeen patients were treated with APC. An argon gas flow of 2 l/min was used at a power setting of 60 W. The follow-up period of the 17 patients ranged from 13 to 87 months (median, 68 months).

Results

The depth of tumor invasion, estimated by endoscopy, was mucosal in all patients. Seventy-three sessions (mean, 4.3 sessions/person; range, 1–12 sessions) were performed. All lesions were easily irradiated. No serious complications such as bleeding, perforation, or stenosis occurred. Complete local control was achieved in 16 of the 17 patients, but the remaining patient required further surgery. Death occurred in 3 cases. Two patients died as a result of other disease, and 1 patient died of other carcinomas, but no patient died of esophageal carcinoma.

Conclusion

APC is a safe and effective method for the treatment of local recurrence of squamous cell carcinoma of the esophagus after an EMR.

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References

  1. Inoue H, Tani M, Nagai K, Kawano T, Takeshita K, Endo M, et al. Treatment of esophageal and gastric tumors. Endoscopy 1999;31:47–55.

    Article  PubMed  CAS  Google Scholar 

  2. Ahmad NA, Kochman ML, Long WB, Furth EE, Ginsberg GG. Efficacy, safety, and clinical outcomes of endoscopic mucosal resection: a study of 101 cases. Gastrointest Endosc 2002;55:390–396.

    Article  PubMed  Google Scholar 

  3. Shimizu Y, Tsukagoshi H, Fujita M, Hosokawa M, Kato M, Asaka M. Long-term outcome after endoscopic mucosal resection in patients with esophageal squamous cell carcinoma invading the muscularis mucosa or deeper. Gastrointest Endosc 2002;56:387–390.

    Article  PubMed  Google Scholar 

  4. Katada C, Muto M, Manabe T, Ohtsu A, Yoshida S. Local recurrence of squamous-cell carcinoma of the esophagus after EMR. Gastrointest Endosc 2005;61:219–225.

    Article  PubMed  Google Scholar 

  5. Nomura T, Boku N, Ohtsu A, Muto M, Matsumoto S, Tajiri H, et al. Recurrence after endoscopic mucosal resection for superficial esophageal cancer. Endoscopy 2000;32:277–280.

    Article  PubMed  CAS  Google Scholar 

  6. Shimizu Y, Tsukagoshi H, Fujita M, Hosokawa M, Kato M, Asaka M. Metachronous squamous cell carcinoma of the esophagus arising after endoscopic mucosal resection. Gastrointest Endosc 2001;54:190–194.

    PubMed  CAS  Google Scholar 

  7. Kumagai Y, Kawano T, Nagai K, Inoue H, Nara T, Ami K, et al. Multiple primary esophageal cancer (in Japanese with English abstract). Stomach Intest 2001;36:1021–1025.

    Google Scholar 

  8. Inoue H, Kawano T, Tani M, Takeshita K, Iwai T. Endoscopic mucosal resection using a cap: techniques for use and preventing perforation. Can J Gastroenterol 1999;13:477–480.

    PubMed  CAS  Google Scholar 

  9. Tanaka Y, Shimada H, Makuuchi H. APC supplementary to EMR for superficial esophageal cancer (in Japanese with English abstract). Endosc Dig 1998;10:1609–1613.

    Google Scholar 

  10. Roach SK, Kozarek RA, Raltz SL, Sumida SE. In vitro evaluation of integrity and sterilization of single-use argon plasma coagulation probes. Am J Gastroenterol 1999;94:139–143.

    Article  PubMed  CAS  Google Scholar 

  11. Grund KE, Storek D, Farin G. Endoscopic argon plasma coagulation (APC); first clinical experiences in flexible endoscopy. Endoscopy 1994;2:42–46.

    CAS  Google Scholar 

  12. Watson JP, Benenett MK, Griffin SM, Matthewson K. The tissue effect of argon plasma coagulation and gastric mucosa Gasrtointest Endosc 2000;52:94–95.

    Google Scholar 

  13. Mitsufuji S, Nagoshi M, Tatsumi Y, Sakai M, Shiomi S, Wakabayashi N, et al. Argon plasma coagulation: in vivo tissue damage to the esophagus and stomach and clinical efficacy for early esophageal and gastric cancer. Dig Endosc 2005;17:21–27.

    Article  Google Scholar 

  14. Katsuta M, Tajiri T, Nomura T, Miyashita M, Futami R, Makino H, et al. Treatment of superficial esophageal cancer by argon plasma coagulation. J Nippon Med School 2002;69:383–385.

    Article  Google Scholar 

  15. Kawada K, Kawano T, Momma K, et al. New argon plasma coagulation method for superficial esophageal carcinomas: argon plasma coagulation-subepithelial ablation. Dig Endosc 2007;19:147–152.

    Article  Google Scholar 

  16. Farin G, Grund KE. Technology of argon plasma coagulation with particular regard to endoscopic applications. Endosc Surg 1994;2:71–77.

    CAS  Google Scholar 

  17. Nemoto K, Takai K, Ogawa Y, Sakayauchi T, Sugawara T, Jingu K, et al. Salvage radiation therapy for residual superficial esophageal cancer after endoscopic mucosal resection. Int J Radiat Oncol Biol Phys 2005;63:1290–1294.

    Article  PubMed  Google Scholar 

  18. Eickhoff A, Jakobs R, Weickert U, Hartmann D, Schilling D, Alsenbesy M, et al. Long-segment early squamous carcinoma of the proximal esophagus: curative treatment and long-term follow-up after 5-aminolevulinic acid (5-ALA)-photodynamic therapy. Endoscopy 2006;38:641–643.

    Article  PubMed  CAS  Google Scholar 

  19. Oyama T, Tomori A, Hotta K, Morita S, Kominato K, Tanaka M, et al. Endoscopic submucosal dissection of early esophageal cancer. Clin Gastroenterol Hepatol 2005;3:S67–70.

    Article  PubMed  Google Scholar 

  20. Murakami M, Nishino K, Inoue A, Takaoka Y, Iwamasa K, Murakami B, et al. Argon plasma coagulation for the treatment of early gastric cancer. Hepato-Gastroenterology 2004;51:1658–1661.

    PubMed  Google Scholar 

  21. Sagawa T, Takayama T, Oku T, Hayashi T, Ota H, Okamoto T, et al. Argon plasma coagulation for successful treatment of early gastric cancer with intramucosal invasion. Gut 2003;52:334–339.

    Article  PubMed  CAS  Google Scholar 

  22. Kitamura T, Tanabe S, Koizumi W, Mitomi H, Saigenji K. Argon plasma coagulation for early gastric cancer: technique and outcome. Gastrointest Endosc 2006;63:55–59.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Kenro Kawada, Tatsuyuki Kawano, Kagami Nagai, Tetsuro Nishikage, Yasuaki Nakajima, Kazuo Ogiya, Shigeo Haruki & Tomoyoshi Suzuki

  2. Department of Pathology, Tokyo Medical and Dental University, Tokyo, Japan

    Hiroshi Kawachi

Authors
  1. Kenro Kawada
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  2. Tatsuyuki Kawano
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  3. Kagami Nagai
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  4. Tetsuro Nishikage
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  5. Yasuaki Nakajima
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  6. Kazuo Ogiya
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  7. Shigeo Haruki
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  8. Tomoyoshi Suzuki
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  9. Hiroshi Kawachi
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Correspondence to Kenro Kawada.

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Kawada, K., Kawano, T., Nagai, K. et al. Argon plasma coagulation for local recurrence of squamous cell carcinoma of the esophagus after endoscopic mucosal resection: technique and outcome. Esophagus 5, 27–32 (2008). https://doi.org/10.1007/s10388-007-0142-8

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  • DOI: https://doi.org/10.1007/s10388-007-0142-8

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