Endoscopic resection of early squamous neoplasia of the oesophagus: long-term follow-up in a UK population from a tertiary hospital

被引:1
|
作者
Kuan, Jen Yee [1 ]
Baskind, Sameul [2 ]
Kim, Yeson [1 ]
McGrath, Stephen [3 ]
Chaparala, Ramakrishna [4 ]
Assadsangabi, Arash [2 ]
Prasad, Neeraj [2 ]
Regi, George [5 ]
Ang, Yeng [2 ,6 ]
机构
[1] Univ Manchester, Fac Biol Med & Hlth, Manchester, Lancs, England
[2] Salford Royal NHS Fdn Trust, Dept Gastroenterol, Salford M6 8HD, Lancs, England
[3] Salford Royal NHS Fdn Trust, Dept Pathol, Salford, Lancs, England
[4] Salford Royal NHS Fdn Trust, Dept Upper GI Surg, Salford, Lancs, England
[5] Acute Pennine NHS Fdn Trust, Rochdale Infirm, Dept Gastroenterol, Rochdale, England
[6] Univ Manchester, DEG Div, FBMH, GI Sci, Manchester, Lancs, England
关键词
early oesophageal cancer; endoscopic mucosal resection; endoscopic resection; endoscopic submucosal dissection; oesophageal squamous cell carcinoma; SUBMUCOSAL DISSECTION; MUCOSAL RESECTION; CLINICAL-OUTCOMES; CANCER; DIAGNOSIS; LESIONS;
D O I
10.1097/MEG.0000000000001692
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Aim To review the efficacy and outcomes of endoscopic resection in the diagnosis and treatment of oesophageal squamous dysplasia and early neoplasia. Methods This was a retrospective study between May 2012-2018. Twenty-one patients were treated with or considered for treatment with endoscopic resection at a tertiary hospital in the UK. The primary outcome was curative resection, defined as histologically proven complete resection of the lesion with deep/vertical margin >= 1 mm from neoplasia. Secondary outcomes were changes in staging from endoscopic resection histology, whether there was a complete reversal of dysplasia at 12-months or the latest endoscopic follow-up and 5-year overall survival rate. Results Seventeen patients (mean age = 66.5 years) with 20 lesions (35% en-bloc; 65% piecemeal resections) had endoscopic resection performed. Complete resection was achieved in 90% of lesions by endoscopic criteria, but this was confirmed in fewer lesions histologically. Curative resection was achieved histologically in 60% of lesions (11 patients) and noncurative resection in 40% of lesions (6 patients). Changes in staging from endoscopic resection histology were found in 79.2% of lesions (41.7% upstaged; 37.5% downstaged). No patients were found to have recurrence at their 12-month endoscopic follow-up. Eight of the 11 patients (72.7%) with curative resection remained clear of dysplasia/neoplasia throughout their follow-up (mean, 24.3 months; median, 19 months). The five-year overall survival rate was 64%. Conclusion In UK, endoscopic resection is useful in the management of early squamous neoplasia both for staging and (by piecemeal endoscopic resection in elderly unfit) for medium- to long-term disease clearance.
引用
收藏
页码:789 / 796
页数:8
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