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A retrospective study of endoscopic resection for 368 patients with early esophageal squamous cell carcinoma or precancerous lesions

Abstract

Background

To retrospectively investigate the clinicopathological features and prognosis of early esophageal squamous cell neoplasm (ESCN) treated with endoscopic resection (ER), especially, to compare the prognosis in patients with sm2 cancer and non-sm2 cancer.

Methods

From 2007 to 2013, 368 patients were included in our analysis.

Results

The patients were 252 (68.5 %) men and 116 (31.5 %) women with a median age of 61 (range 16–84 years) years. Hyperplasia, mild dysplasia, moderate dysplasia, severe dysplasia, m1, m2, m3, sm1, and sm2 were diagnosed in 47 (12.8 %), 27 (7.3 %), 34 (9.2 %), 61 (16.6 %), 54 (14.7 %), 38 (10.3 %), 63 (17.1 %), 12 (3.3 %), and 32 (8.7 %) cases. The mean (range) follow-up time was 29 (0–84) months. The cumulative overall 1-, 3-, and 5-year metachronous esophageal lesion rates were 4.1, 12.9, and 32.6 %. The incidence of lymph node or distant metastasis was 1.54 % in m3, 6.25 % in sm2, and 0 in other subgroups. The overall 1-, 3-, and 5-year survival rates were 99.5, 97.3, and 87.5 %. There was significant difference between sm2 and non-sm2 patients in metastatic rate (P = 0.021); however, no difference existed between m3 patients and sm2 patients (P = 0.252). The difference of metachronous esophageal lesion (P = 0.401) and survival (P = 0.634) between sm2 and non-sm2 patients was not obvious.

Conclusions

Our study showed that ER was an effective and relatively safe treatment for superficial ESCN. ER is still appropriate in select sm2 patients. To monitor the second primary cancer in sm2 is necessary during the follow-up.

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Acknowledgments

This work was supported by Shanghai Municipal Commission of Health and Family Planning, Key Developing Disciplines (No. 2015ZB0201).

Author information

Correspondence to Yingyong Hou or Yunshi Zhong.

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Disclosure

Dongxian Jiang, Xuquan Li, Haixing Wang, Chen Xu, Xiaojing Li, Akesu Sujie, Haiying Zeng, Yunshi Zhong, and Yingyong Hou have no conflicts of interest or financial ties to disclose.

Additional information

Dongxian Jiang and Xuquan Li have contributed equally to this work.

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Jiang, D., Li, X., Wang, H. et al. A retrospective study of endoscopic resection for 368 patients with early esophageal squamous cell carcinoma or precancerous lesions. Surg Endosc 31, 2122–2130 (2017). https://doi.org/10.1007/s00464-016-5208-z

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Keywords

  • Early esophageal cancer or precancerous lesion
  • Endoscopic resection
  • Pathology
  • sm2
  • Prognosis