Philippe Bouchard1, Juan-Carlos Molina1,2, Jonathan Cools-Lartigue1,2, Jonathan Spicer1,2, Carmen L Mueller1,2, Lorenzo E Ferri3,4. 1. McGill University, Montreal, QC, Canada. 2. Division of Thoracic and Upper Gastrointestinal Surgery, McGill University, 1650 Cedar Avenue, L8-505, Montreal, QC, H3G 1A4, Canada. 3. McGill University, Montreal, QC, Canada. Lorenzo.ferri@mcgill.ca. 4. Division of Thoracic and Upper Gastrointestinal Surgery, McGill University, 1650 Cedar Avenue, L8-505, Montreal, QC, H3G 1A4, Canada. Lorenzo.ferri@mcgill.ca.
Abstract
BACKGROUND: Data are limited regarding the application of endoscopic submucosal dissection (ESD) in Western countries or for esophageal adenocarcinoma in any part of the world. We sought to review our experience employing ESD in patients with early esophageal cancer at a high volume North American esophageal cancer treatment center. METHODS: A prospectively maintained database of all patients with esophageal cancer treated at the McGill University Health Center was used to identify ESDs performed for adenocarcinoma between 2012 and 2016. Patient demographics, pre-resection tumor characteristics, endoscopic resection technical variables, pathologic results, and short- and long-term outcomes were recorded. RESULTS: Of 650 patients in the database, 26 underwent 27 procedures. The majority (67%) had pre-treatment EUS. There were no post-ESD bleeding events requiring re-intervention. Perforation occurred in 2/27 (7%), one of which required operative repair. Complete RO resection was achieved in 18/27(67%). Salvage laparoscopic esophagectomy was performed in six patients. At a median follow-up of 18.5 (7-35) months, cancer recurrence occurred in only one patient who subsequently underwent successful repeat ESD. CONCLUSIONS: Although technically challenging, ESD represents a safe and effective treatment of early esophageal adenocarcinoma and has the potential to become a more important tool in management of these early lesions in Western countries.
BACKGROUND: Data are limited regarding the application of endoscopic submucosal dissection (ESD) in Western countries or for esophageal adenocarcinoma in any part of the world. We sought to review our experience employing ESD in patients with early esophageal cancer at a high volume North American esophageal cancer treatment center. METHODS: A prospectively maintained database of all patients with esophageal cancer treated at the McGill University Health Center was used to identify ESDs performed for adenocarcinoma between 2012 and 2016. Patient demographics, pre-resection tumor characteristics, endoscopic resection technical variables, pathologic results, and short- and long-term outcomes were recorded. RESULTS: Of 650 patients in the database, 26 underwent 27 procedures. The majority (67%) had pre-treatment EUS. There were no post-ESD bleeding events requiring re-intervention. Perforation occurred in 2/27 (7%), one of which required operative repair. Complete RO resection was achieved in 18/27(67%). Salvage laparoscopic esophagectomy was performed in six patients. At a median follow-up of 18.5 (7-35) months, cancer recurrence occurred in only one patient who subsequently underwent successful repeat ESD. CONCLUSIONS: Although technically challenging, ESD represents a safe and effective treatment of early esophageal adenocarcinoma and has the potential to become a more important tool in management of these early lesions in Western countries.
Entities:
Keywords:
Endoscopic submucosal dissection; Esophageal adenocarcinoma; Esophageal cancer
Authors: John D Birkmeyer; Andrea E Siewers; Emily V A Finlayson; Therese A Stukel; F Lee Lucas; Ida Batista; H Gilbert Welch; David E Wennberg Journal: N Engl J Med Date: 2002-04-11 Impact factor: 91.245
Authors: David P Kelsen; Katryn A Winter; Leonard L Gunderson; Joanne Mortimer; Norman C Estes; Daniel G Haller; Jaffer A Ajani; Walter Kocha; Bruce D Minsky; Jack A Roth; Christopher G Willett Journal: J Clin Oncol Date: 2007-08-20 Impact factor: 44.544
Authors: Jin Ra; E Carter Paulson; John Kucharczuk; Katrina Armstrong; Christopher Wirtalla; Rachel Rapaport-Kelz; Larry R Kaiser; Francis R Spitz Journal: Ann Surg Oncol Date: 2008-04-01 Impact factor: 5.344
Authors: E Bollschweiler; S E Baldus; W Schröder; K Prenzel; C Gutschow; P M Schneider; A H Hölscher Journal: Endoscopy Date: 2006-02 Impact factor: 10.093
Authors: Henna K Söderström; Jari Räsänen; Juha Saarnio; Vesa Toikkanen; Tuula Tyrväinen; Tuomo Rantanen; Antti Valtola; Pasi Ohtonen; Minna Pääaho; Arto Kokkola; Raija Kallio; Tuomo J Karttunen; Vesa-Matti Pohjanen; Ari Ristimäki; Simo Laine; Eero Sihvo; Joonas H Kauppila Journal: BMJ Open Date: 2020-10-14 Impact factor: 2.692