The five-year survival rate after endoscopic submucosal dissection for superficial esophageal squamous cell neoplasia

Dig Liver Dis. 2017 Apr;49(4):427-433. doi: 10.1016/j.dld.2016.12.009. Epub 2016 Dec 21.

Abstract

Background: Endoscopic submucosal dissection (ESD) is a widely accepted procedure for superficial esophageal squamous cell neoplasia (ESCN) because of a high complete resection rate. However, there were a few reports about the long-term outcomes of these patients due to short follow-up periods.

Aims: We aimed to evaluate the 5-year survival after ESD for superficial ESCN.

Methods: This was a retrospective cohort study performed at a single institution. Between 2006 and 2009, 94 patients with superficial ESCN underwent ESD. Eighty-three patients (93.3%) who had completed an extended period of observation of at least 5 years were enrolled. The main outcomes were the 5-year survival rates. The secondary outcomes were the cumulative incidence rate of metachronous ESCN, and the clinical outcomes.

Results: The 5-year relative overall survival rate was 99.0%, whereas the cause specific survival rate was 100% during 72.9 months of median follow up period. Subgroup analysis showed that the 5year survival of patients with EP/LPM and MM/SM1 (submucosal invasion ≤200μm) were 100% and 89.0%, respectively. The cumulative incidence rate of metachronous ESCN at 5 years was 16.8%.

Conclusion: ESD for superficial ESCN is a curative treatment with a favorable 5-year survival rate.

Keywords: Esophageal cancer; Long term outcome; Metachronous cancer; Relative survival rate.

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / surgery*
  • Dissection
  • Endoscopic Mucosal Resection
  • Esophageal Neoplasms / mortality*
  • Esophageal Neoplasms / surgery*
  • Esophagoscopy
  • Female
  • Humans
  • Japan
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasms, Second Primary / epidemiology*
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome