Curative Criteria After Endoscopic Resection for Superficial Esophageal Squamous Cell Carcinomas
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According to the Japanese Esophageal Society (JES) guidelines, risk factors for lymph node (LN) metastasis in the muscularis mucosa (MM)/submucosa to a depth of up to 200 μm (SM1) in cases of esophageal squamous cell carcinomas (ESCCs) include the presence of lymphatic invasion (ly), venous invasion (v), infiltration pattern (INF)c, and SM1. The long-term prognoses of these patients are unclear, and there are very few reports on the validation of the curative criteria for MM/SM1 ESCCs.
To examine the long-term prognoses of these patients and the risk factors for LN metastasis of MM/SM1 ESCCs after endoscopic resection (ER).
This study included patients with MM/SM1 ESCCs who underwent ER at Hiroshima University Hospital from December 1990 to November 2016. We evaluated the clinicopathological characteristics of 98 patients and overall survival, disease-specific survival, recurrence-free survival, and recurrence rates in the e-curative and non-e-curative groups.
The mean observation period was 75 months. There was no significant difference in disease-specific survival rate between the e-curative and non-e-curative groups (100 vs. 98%). There was no significant difference in disease-specific survival rates between the groups (100 vs. 98%). In contrast, the LN recurrence-free survival rate in patients with INFa, ly(−), and v(−) was significantly higher than that in patients with INFb/c, ly(+), or v(+) (100 and 87%, P < 0.05).
Contrary to the JES guidelines, our findings suggest that new criteria (MM/SM1, INFa, negative vertical margin (VM0), ly[-], and v[-]) may be associated with curative ER without additional treatment.
KeywordsEsophageal cancers Endoscopic treatment Endoscopic resection Prognosis Metastasis
TK and TH were involved in study conception and design; TK, NY, KK, MK, YY, YS, YU, YM, SO, and KA analyzed the data; ST and KC critically revised the manuscript for ensuring accuracy of content; and TK and TH wrote the manuscript.
Compliance with ethical standards
Conflict of interest
All the authors declare that they have no conflict of interests.
- 5.Ono H. Endoscopic submucosal dissection for early gastric cancer. J Dig Dis. 2005;6:119–121.Google Scholar
- 20.Oyama T. Lymph nodal metastasis of M3, SM1 esophageal cancer. Stom Intest. 2002;37:71–74. (in Japanese).Google Scholar
- 22.The Japanese Esophageal Society. Guidelines for the Clinical and Pathologic Studies on Carcinoma of the Esophagus. Tokyo: Kanehara & Co Ltd.; 2012. (in Japanese).Google Scholar
- 28.Arima M, Yamada T, Tsunomiya I, et al. Strategies for treatment and follow-up observation of patients with superficial esophageal cancer. Shoukakinaisikyou. 2012;24:1237–1244. (in Japanese).Google Scholar
- 32.Kurokawa Y, Muto M, Minashi K, Boku N, Fukuda H, Gastrointestinal Oncology Study Group of Japan Clinical Oncology Group. A phase II trial of combined treatment of endoscopic mucosal resection and chemoradiotherapy for clinical stage I esophageal carcinoma: Japan Clinical Oncology Group Study JCOG0508. Jpn J Clin Oncol. 2009;39:686–689.CrossRefPubMedPubMedCentralGoogle Scholar