Guo-qing Wang1, Chang-qing Hao, Wen-qiang Wei, Lin Zhao. 1. Department of Endoscopy, Cancer Hospital, Chinese Acadamy of Medical Sciences and Peking Union Medical Sciences, Beijing 100021, China (Email: wgq2581@yahoo.com.cn).
Abstract
OBJECTIVE: To evaluate the long-term outcomes of endoscopic argon plasma coagulation (APC) therapy for early esophageal cancer and precancerous lesions. METHODS: One-hundred and seventy-one cases with early esophageal cancer (intramucosal carcinoma) and precancerous lesions were treated by APC from 1994 to 2005, and all the cases were followed up. One-hundred and sixty-eight (98.2%) cases were follow-up by endoscopic examination for several times. On average, each patient was endoscopically examined 2.8 times. The follow-up rate was 100%. RESULTS: The precancerous lesion group had 160 patients. They were followed up for 5 years. 11 patients died of causes unrelated to cancer. The lesions developed into esophageal squamous cell carcinoma in five patients ( 2 died and 3 underwent esophagectomy). The remaining 144 cases survived without cancer. In this group, the esophageal cancer incidence rate is only 3.1% (5/160). The early cancer (i.e. intramucosal cancer) group had 11 patients. During the 5-year follow-up period, two patients died of causes unrelated to cancer,six patients had recurrence (4 patients died and 2 patients underwent esophagectomy), and only 3 patients survived without cancer. Therefore, the 5-year survival rate was only 27.3% (3/11). CONCLUSIONS: The APC therapy for precancerous lesions of the esophagus is effective and successful. Indications should be carefully considered when treating early esophageal cancer such as intramucosal carcinoma by APC therapy.
OBJECTIVE: To evaluate the long-term outcomes of endoscopic argon plasma coagulation (APC) therapy for early esophageal cancer and precancerous lesions. METHODS: One-hundred and seventy-one cases with early esophageal cancer (intramucosal carcinoma) and precancerous lesions were treated by APC from 1994 to 2005, and all the cases were followed up. One-hundred and sixty-eight (98.2%) cases were follow-up by endoscopic examination for several times. On average, each patient was endoscopically examined 2.8 times. The follow-up rate was 100%. RESULTS: The precancerous lesion group had 160 patients. They were followed up for 5 years. 11 patients died of causes unrelated to cancer. The lesions developed into esophageal squamous cell carcinoma in five patients ( 2 died and 3 underwent esophagectomy). The remaining 144 cases survived without cancer. In this group, the esophageal cancer incidence rate is only 3.1% (5/160). The early cancer (i.e. intramucosal cancer) group had 11 patients. During the 5-year follow-up period, two patients died of causes unrelated to cancer,six patients had recurrence (4 patients died and 2 patients underwent esophagectomy), and only 3 patients survived without cancer. Therefore, the 5-year survival rate was only 27.3% (3/11). CONCLUSIONS: The APC therapy for precancerous lesions of the esophagus is effective and successful. Indications should be carefully considered when treating early esophageal cancer such as intramucosal carcinoma by APC therapy.