Gastrointestinal endoscopy · 2026
Clinical outcomes of circumferential endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma: a retrospective study.
СтатьяНазвание и аннотация: Перевод в очереди
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Dai Nan, Guo Changqing, Liu Ping, Zhang Fangbin, Zhou Haining, Zhu Shanshan, Liu Zhen, Li Xiangnan, Zhao Jia, Lu Guifang, Yin Yan, Li Yarui, Ren Mudan, He Shuixiang, Cao Xinguang
Аннотация
BACKGROUND AND AIMS: Circumferential endoscopic submucosal dissection (C-ESD) is increasingly used for circumferential superficial esophageal squamous cell carcinoma (C-ESCC), although outcome data remain sparse. This study aimed to evaluate the short- and long-term outcomes of C-ESD in patients with C-ESCC.
METHODS: Clinical outcomes of patients with C-ESCC undergoing C-ESD at 2 Chinese centers were analyzed. Short-term outcomes included en bloc resection rate, curative resection rate, operation time, and adverse events. Long-term outcomes comprised overall survival (OS), disease-specific survival (DSS), cumulative recurrence rate (CRR), and the efficacy of stricture prevention and management.
RESULTS: A final assessment was conducted in 100 patients (100 lesions). The median lesion length was 5.2 cm (IQR, 4.5-6.0). Technical success rates were as follows: en bloc resection, 92.0% (95% CI, 85.0-96.4); R0 resection, 84.0% (95% CI, 75.6-90.5); and curative resection, 81.0% (95% CI, 72.3-88.3). The median procedure duration was 97.5 minutes (IQR, 70.5-138.3). Adverse events included delayed bleeding (3.0%), perforation (1.0%), and strictures (88.0%). With a median follow-up of 47.4 months (IQR, 34.3-65.2), 3- and 5-year OS and DSS were identical at 95.6% (95% CI, 91.4-99.9). Cumulative recurrence increased from 16.2% (3 years) to 19.8% (5 years). Prophylactic measures reduced stricture incidence (80% vs 100%; P = .007) and median number of endoscopic dilation sessions, 3 (IQR, 1-6) versus 4 (IQR, 3-9.8); P = .028. Stricture resolution was achieved in 95.5% of cases.
CONCLUSIONS: C-ESD is an effective treatment for C-ESCCs. Although it achieves reliable oncological control with a favorable prognosis, its value is tempered by high stricture rates and a nonnegligible recurrence risk (∼20%). To optimize patient outcomes, advancing stricture prevention and ensuring rigorous long-term management are crucial future directions.
METHODS: Clinical outcomes of patients with C-ESCC undergoing C-ESD at 2 Chinese centers were analyzed. Short-term outcomes included en bloc resection rate, curative resection rate, operation time, and adverse events. Long-term outcomes comprised overall survival (OS), disease-specific survival (DSS), cumulative recurrence rate (CRR), and the efficacy of stricture prevention and management.
RESULTS: A final assessment was conducted in 100 patients (100 lesions). The median lesion length was 5.2 cm (IQR, 4.5-6.0). Technical success rates were as follows: en bloc resection, 92.0% (95% CI, 85.0-96.4); R0 resection, 84.0% (95% CI, 75.6-90.5); and curative resection, 81.0% (95% CI, 72.3-88.3). The median procedure duration was 97.5 minutes (IQR, 70.5-138.3). Adverse events included delayed bleeding (3.0%), perforation (1.0%), and strictures (88.0%). With a median follow-up of 47.4 months (IQR, 34.3-65.2), 3- and 5-year OS and DSS were identical at 95.6% (95% CI, 91.4-99.9). Cumulative recurrence increased from 16.2% (3 years) to 19.8% (5 years). Prophylactic measures reduced stricture incidence (80% vs 100%; P = .007) and median number of endoscopic dilation sessions, 3 (IQR, 1-6) versus 4 (IQR, 3-9.8); P = .028. Stricture resolution was achieved in 95.5% of cases.
CONCLUSIONS: C-ESD is an effective treatment for C-ESCCs. Although it achieves reliable oncological control with a favorable prognosis, its value is tempered by high stricture rates and a nonnegligible recurrence risk (∼20%). To optimize patient outcomes, advancing stricture prevention and ensuring rigorous long-term management are crucial future directions.
Предметные рубрики MeSH
HumansEndoscopic Mucosal ResectionEsophageal NeoplasmsRetrospective StudiesMaleFemaleNeoplasm Recurrence, LocalEsophageal StenosisMiddle AgedAgedEsophageal Squamous Cell CarcinomaOperative TimeTreatment OutcomeSurvival RateCarcinoma, Squamous CellEsophageal PerforationPostoperative HemorrhagePostoperative Complications