Treatment Outcomes of Endoscopic Submucosal Dissection for Adenocarcinoma Originating from Long-Segment Barrett's Esophagus versus Short-Segment Barrett's Esophagus

Digestion. 2018;97(4):316-323. doi: 10.1159/000486197. Epub 2018 Mar 14.

Abstract

Background: In recent years, effective outcomes of endoscopic submucosal dissection (ESD) for esophagogastric junction cancer including short-segment Barrett's esophagus (SSBE) cancer have been reported. However, the efficacy of ESD for long-segment Barrett's esophagus (LSBE) cancer is unknown.

Aim: To clarify the treatment outcomes of ESD for LSBE cancer versus SSBE cancer.

Methods: A total of 86 patients with 91 superficial Barrett's esophageal adenocarcinomas who underwent ESD were enrolled; of these, 68 had underlying SSBE and 18 had LSBE. Procedure outcomes and prognosis were compared.

Results: There was no significant difference in age and tumor diameter among patients. The only complication observed was stricture, but it was not significant (2 vs. 9%). No significant difference was observed in the negative horizontal margin rates (94.1 vs. 95.7%), R0 resection rates (83.8 vs. 82.6%), curative resection rates (72.1 vs. 73.9%), and noncurative factors. Both LSBE and SSBE cancer showed favorable 3-year overall survival rates (95.0 vs. 94.4%) in the median observation period of 28.5 months.

Conclusions: ESD for LSBE cancer achieved procedure outcomes and short-term prognosis comparable to SSBE. ESD has the potential to be an effective therapeutic option for esophageal neoplasms in patients with LSBE.

Keywords: Barrett esophagus; Endoscopic mucosal resection; Esophageal neoplasms; Narrow band imaging; Treatment outcome.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Aged
  • Barrett Esophagus / mortality
  • Barrett Esophagus / pathology*
  • Barrett Esophagus / surgery
  • Endoscopic Mucosal Resection / adverse effects*
  • Endoscopic Mucosal Resection / methods
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery*
  • Esophageal Stenosis / epidemiology
  • Esophageal Stenosis / etiology
  • Esophagoscopy / adverse effects*
  • Esophagoscopy / methods
  • Esophagus / physiology
  • Esophagus / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome

Supplementary concepts

  • Adenocarcinoma Of Esophagus