Esophagectomy for superficial esophageal cancer after non-curative endoscopic resection

Hiroshi Saeki, Masayuki Watanabe, Shinji Mine, Hironobu Shigaki, Shuichiro Oya, Akiyoshi Ishiyama, Tomohiro Tsuchida, Junko Fujisaki, Hideo Baba, Yoshihiko Maehara, Takeshi Sano

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9 Citations (Scopus)

Abstract

Background: Additional surgical treatment after non-curative endoscopic resection for superficial esophageal cancer should be considered unless the tumor is pathologically proven to be categorized within the absolute indication of endoscopic resection. However, the significance of this treatment strategy has been poorly evaluated until now. Methods: Additional esophagectomy with lymph node dissection was carried out for a total of 34 patients with esophageal cancer pathologically diagnosed as in contact with or invading the muscularis mucosa (pT1a-MM) or submucosa (pSM) and/or accompanying vascular permeation after endoscopic resection. The surgical results, pathological diagnosis after esophagectomy, and outcomes were analyzed. Results: The pathological diagnosis after endoscopic resection revealed pT1a-MM in 7 patients, pSM in 27 patients, and vessel permeation in 24 patients. The approach to esophagectomy was via right and left thoracotomy in 26 patients and 2 patients, respectively, and was transhiatal in 6 patients. Three-field lymph node dissection was performed in 12 patients, and the mean number of dissected lymph nodes was 72 (range 31–132). Pathological lymph node metastasis was noted in 10 patients. Postoperative complications developed in 10 patients, and death due to pulmonary complications was observed in one patient. No postoperative recurrence was observed during the follow-up period (1–87 months). Conclusions: Esophagectomy after endoscopic resection provides favorable disease control for esophageal cancer with pT1a-MM/pSM and/or vessel permeation, while strict consideration is required to determine the indication and procedure for surgery because of its invasiveness.

Original languageEnglish
Pages (from-to)406-413
Number of pages8
JournalJournal of gastroenterology
Volume50
Issue number4
DOIs
Publication statusPublished - Apr 1 2015

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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