Clinical Outcomes of the Endoscopic Treatments for the Early Esophageal Carcinoma and Dysplasia

Kim, Cheol; Hong, Su Jin; Han, Jae Pil; Jung, Hee Jae; Jeong, Eun Soo; Goong, Hyeon Jeong; Kim, Heejun; Lee, Seoung Ho; Ko, Bong Min; Lee, Moon Sung

doi:2014.14.3.187

Korean J Helicobacter Up Gastrointest Res > Volume 14(3); 2014 > Article

Original Article

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2014;14(3):187-193.
DOI: https://doi.org/10.7704/kjhugr.2014.14.3.187 Published online September 10, 2014.

Clinical Outcomes of the Endoscopic Treatments for the Early Esophageal Carcinoma and Dysplasia

Cheol Kim, Su Jin Hong, Jae Pil Han, Hee Jae Jung, Eun Soo Jeong, Hyeon Jeong Goong, Heejun Kim, Seoung Ho Lee, Bong Min Ko, Moon Sung Lee

Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea. sjhong@schmc.ac.kr

조기 식도암과 이형성에서 내시경 치료의 임상 성적

김 철, 홍수진, 한재필, 정희재, 정은수, 궁현정, 김희준, 이승호, 고봉민, 이문성

순천향대학교 의과대학 내과학교실

Abstract

BACKGROUND/AIMS
Esophageal cancer and dysplasia are relatively rare in Korea, compared to other Far Eastern countries. So, the feasibility and safety of endoscopic treatments for these diseases is not well established in Korea. This study aimed to assess the technical feasibility, safety and the clinical outcomes of endoscopic treatment for esophageal epithelial lesions. MATERIALS AND METHODS: Between April 2005 and March 2013, 25 esophageal epithelial lesions from 22 patients were treated with endoscopic treatment such as endoscopic submucosal dissection or endoscopic mucosal resection. RESULTS: Of the 25 lesions, 11 lesions were treated with endoscopic submucosal dissection (ESD) (ESD group) and 14 lesions with endoscopic mucosal resection (EMR group). In the ESD group, the diagnosis was squamous cell carcinoma in 7 patients (64%), high grade dysplasia in 3 patients (27%), and low grade dysplasia in 1 patient (9%). In the EMR group, thediagnosis was squamous cell carcinoma in 8 patients (57%), high grade dysplasia in 2 patients (14%), and low grade dysplasia in 4 patients (29%). En bloc resection rates were 100% in ESD and 42.9% in EMR, respectively. For the median 12 months follow up period, there was no recurrence in the ESD group. However, there were three recurrences in the EMR group. CONCLUSIONS: Endoscopic treatment for esophageal epithelial lesions is safe and feasible therapeutic modalities. Especially, ESD can provide higher rate of en bloc and curative resection for early esophageal cancer and dysplasia.

Key Words: Early esophageal cancer; Esophageal dysplasia; Endoscopic submucosal dissection; Endoscopic mucosal resection