Clinical outcomes of endoscopic resection of preoperatively diagnosed non-circumferential T1a-muscularis mucosae or T1b-submucosa 1 esophageal squamous cell carcinoma

• Published in: Scientific reports Vol. 11; no. 1; p. 6554
• Main Authors: Namikawa, Ken, Yoshio, Toshiyuki, Yoshimizu, Shoichi, Ishiyama, Akiyoshi, Tsuchida, Tomohiro, Tokai, Yoshitaka, Horiuchi, Yusuke, Hirasawa, Toshiaki, Fujisaki, Junko
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 22-03-2021; Nature Publishing Group; Nature Portfolio
• Subjects: 631/67/1504/1477; 692/4020/2223; Adult; Aged; Biopsy; Clinical outcomes; Diagnosis; Endoscopy; Esophageal cancer; Esophageal Squamous Cell Carcinoma - diagnosis; Esophageal Squamous Cell Carcinoma - mortality; Esophageal Squamous Cell Carcinoma - surgery; Esophagectomy - methods; Esophagoscopy - methods; Esophagus; Female; Humanities and Social Sciences; Humans; Lamina propria; Lymph nodes; Lymphatic Metastasis; Lymphatic system; Male; Metastases; Middle Aged; Mucosa; multidisciplinary; Neoplasm Invasiveness; Neoplasm Staging; Patients; Prognosis; Risk factors; Science; Science (multidisciplinary); Squamous cell carcinoma; Survival; Treatment Outcome
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-85572-0

In Japan, preoperatively diagnosed T1a-muscularis mucosae or T1b-submucosa 1 (MM/SM1) esophageal squamous cell carcinoma (ESCC) is a relative indication for endoscopic resection (ER). We evaluated long-term outcomes in patients after ER for non-circumferential ESCC with a preoperative diagnosis of MM/SM1 invasion. We retrospectively reviewed 66 patients with a preoperative diagnosis of non-circumferential MM/SM1 ESCC endoscopically resected between 2010 and 2015. Patients were divided into low- (adequate follow-up) and high-risk (requiring additional treatment) groups for lymph node metastasis according to risk factors (submucosal invasion, lymphovascular invasion, or droplet infiltration) and long-term outcomes were analyzed. Pathological invasion to T1a-lamina propria mucosa, MM/SM1, and T1b-SM2 was seen in 22, 38, and 6 lesions, respectively. Overall, 71.2% patients were classified into the “adequate follow-up” group. Of these, only one patient had a lymph node recurrence, which was successfully treated by additional therapy. The remaining 28.8% patients were classified into the “requiring additional treatment” group, where no recurrences were observed after additional treatments. After a median follow-up of 58.6 months, no deaths happened due to ESCC. The 3- and 5-year overall survival rates were 93.6% and 88.7%, respectively. ER is a valid initial treatment for non-circumferential ESCC with preoperatively diagnosed MM/SM1 invasion.