Local recurrence of large squamous-cell carcinoma of the esophagus after endoscopic resection

Ryu Ishihara, Hiroyasu Iishi, Yoji Takeuchi, Motohiko Kato, Sachiko Yamamoto, Shunsuke Yamamoto, Eriko Masuda, Koichi Tatsumi, Koji Higashino, Noriya Uedo, Masaharu Tatsuta

Research output: Contribution to journalArticlepeer-review

101 Citations (Scopus)

Abstract

Background: A new technique, endoscopic submucosal dissection (ESD), which uses specially developed endoscopic knives, was recently developed for en bloc resection of large lesions. Despite increasing indications for endoscopic resection (ER), there are limited data available regarding the outcome of ER for lesions 20 mm or more in diameter. Objective: To investigate the risk factors for local recurrence. Design: Retrospective cohort study. Setting: A cancer-referral center. Patients: Seventy patients, who presented between September 1994 and April 2006, with a total of 78 lesions that measured 20 mm or more in diameter. Main Outcome Measurement: Local recurrence rate after ER was assessed. Results: At a median follow-up of 32 months (range 12-121 months), there were 12 local recurrences (15.4%). There was no significant association between local recurrence and multiple iodine-voiding lesions, tumor size, or tumor location. The number of resections and the resection method, however, were significantly associated with local recurrence. There was no recurrence of lesions treated by en bloc resection. Lesions resected in 5 or more pieces had a significantly higher recurrence rate than lesions resected in 2 to 4 pieces. Lesions treated by EMR had a significantly higher recurrence rate than lesions treated by ESD. Limitations: Single-center retrospective analysis. Conclusions: Esophageal squamous-cell carcinoma that measured 20 mm or more in diameter should be resected en bloc by ESD. Lesions treated by resection in 5 or more pieces have a higher risk for local recurrence.

Original languageEnglish
Pages (from-to)799-804
Number of pages6
JournalGastrointestinal Endoscopy
Volume67
Issue number6
DOIs
Publication statusPublished - 2008 May 1
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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