Abstract:
:Esophagectomy represents the standard treatment strategy for superficial esophageal cancer diagnosed pathologically as submucosal disease (pT1b) following an endoscopic resection (ER). However, chemoradiotherapy (CRT) is expected to become an alternative treatment option. This study retrospectively compared the outcomes of patients who underwent ER of submucosal esophageal squamous cell carcinoma, and who received additional treatment in the form of surgery and CRT. Data were collected from 83 patients who underwent ER and were diagnosed as pT1b (sm) between January 2002 and December 2013. Of them, 52 patients underwent additional treatment (19 surgery, 33 CRT). The long-term outcomes, recurrent patterns, and recurrence risk factor were analyzed retrospectively. No significant differences were identified between the two groups regarding the following aspects: sex, Charlson comorbidity index, tumor size, macroscopic type, cut end positivity, and en bloc resection rate. On the contrary, significant differences were observed in age (P = 0.042) and lymphovascular invasion (P = 0.003) between the two groups. There were more patients with positive lymphovascular invasion, which was one of the strongest risk factors, in the surgery group. The 3-year overall survival (OS) and relapse-free survival (RFS) rates were both 100% in the surgery group and 90.4% and 87.4%, respectively, in the CRT group. The 5-year OS and RFS rates both decreased to 89.5% in the surgery group and to 80.3% and 70.4%, respectively, in the CRT group. The surgery group achieved a superior OS and RFS compared to the CRT group, though not significant (P = 0.172, P = 0.127). Tumor recurrence was observed in 6 patients. All these patients were in the CRT group (P = 0.075). They included 3 patients with hematogenous metastases (of the lung, bone, and adrenal gland) and 3 patients with regional lymph node metastasis. The patient with hematogenous adrenal gland metastasis had simultaneous extended lymph node metastasis. Through a univariate analysis, it was observed that tumor size (≥ 40 mm) and positive lymphatic invasion represented the significant risk factors for recurrence in the CRT group (P = 0.048 and P = 0.035, respectively). To achieve a better long-term survival, surgery is recommended as the additional treatment for ER-pT1b esophageal cancer. While CRT represents an acceptable alternative, the indication should be carefully decided, especially in high-risk patients for recurrence with large tumor size (≥ 40 mm) or positive lymphatic invasion.
journal_name
Dis Esophagusjournal_title
Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagusauthors
Tanaka T,Ueno M,Iizuka T,Hoteya S,Haruta S,Udagawa Hdoi
10.1093/dote/doz023subject
Has Abstractpub_date
2019-12-31 00:00:00issue
12eissn
1120-8694issn
1442-2050pii
5450336journal_volume
32pub_type
杂志文章abstract::Interferon (IFN)-β has efficient antitumor effect both in vitro and in vivo, but its clinical implication is limited by short half-life and systemic toxicities. Gene therapy could be the choice to avoid the defects. Adenovirus vector containing human IFN-β gene was transfected into esophageal squamous cell carcinoma K...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/dote.12081
更新日期:2014-02-01 00:00:00
abstract::Published guidelines for the management of eosinophilic esophagitis (EoE) recommend an initial trial of proton pump inhibitors (PPI), histologic assessment for response to therapy, and tailoring treatments to patient needs and provider resources. Effectiveness studies directly comparing therapies are lacking, leaving ...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/doy133
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abstract::Human esophageal adenocarcinoma (EAC) cell lines have made a substantial contribution to elucidating mechanisms of carcinogenesis and drug discovery. Model research on EAC relies almost entirely on a relatively small set of established tumor cell lines because appropriate animal models are lacking. Nowadays, more than...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
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更新日期:2015-01-01 00:00:00
abstract::The Chemoprevention for Barrett's Esophagus Trial (CBET) was a phase IIb, multicenter, randomized, placebo-controlled trial of celecoxib in patients with Barrett's esophagus. The overall outcome of the study was that there were no significant differences in primary, secondary, or tertiary outcomes. The purpose of the ...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2008-01-01 00:00:00
abstract::Eosinophilic esophagitis (EoE) is an esophageal allergic inflammatory disorder often presenting with infant/toddler gastroesophageal reflux symptoms refractory to treatment, including acid suppression trials with histamine H2 antagonists and proton pump inhibitors. We propose to evaluate the impact of infant acid supp...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/doaa073
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abstract::Squamous cell carcinoma of the esophagus is a cancer with a high incidence in South Africa. We have investigated the prognostic value of telomerase activity in tumors as well as nearby normal tissue. Biopsies from 98 patients (71 men and 27 women) were analyzed using an adaptation of the TRAP assay. We found all tumor...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2004.00417.x
更新日期:2004-01-01 00:00:00
abstract::To determine trends in the diagnostic distribution of esophageal motility disorders after implementation of the Chicago Classification Version 3.0 (CC V3.0) for interpretation of high-resolution manometry (HRM) studies compared to non-Chicago Classification criteria. Retrospective trends analysis of patients with an H...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/dox068
更新日期:2017-12-01 00:00:00
abstract::Minimally invasive esophageal resection is a technically demanding procedure that may reduce patient morbidity and improve convalescence when compared with the open approach. Despite these proposed advantages, the minimally invasive approach has not been widely embraced and is routinely performed in only a few special...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2004.00383.x
更新日期:2004-01-01 00:00:00
abstract::We report the case of a 63-year-old man who presented with weakness, fatigue, dehydration, confusion, abdominal pain, congestive heart failure and hypercalcemia. He expired and autopsy revealed an exulcerating carcinoma of the esophagus, invading the esophageal wall and metastasizing to the lungs, skin and lymph nodes...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2003.00363.x
更新日期:2003-01-01 00:00:00
abstract::A 69-year-old patient underwent simultaneous transhiatal esophagectomy for carcinoma of the esophagogastric junction and benign spindle cell gastric tumor and coronary artery bypass grafting without cardiopulmonary bypass. A standard technique of transhiatal esophagectomy was used. The long saphenous vein was grafted ...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1046/j.1442-2050.1999.00053.x
更新日期:1999-01-01 00:00:00
abstract::This prospective population-based study was designed to evaluate treatment choices in patients with new manometrically diagnosed achalasia and their outcomes. Patients referred to the esophageal function laboratory were enrolled after a new manometric diagnosis of achalasia. Patients completed an initial achalasia sym...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/dote.12348
更新日期:2016-07-01 00:00:00
abstract::Leiomyosarcoma of the esophagus is an uncommon neoplasm of mesenchymal origin. The simultaneous occurrence of leiomyosarcoma and squamous cell carcinoma in the esophagus as separate tumors is a very rare event. We present a case leiomyosarcoma associated with squamous cell carcinoma that was diagnosed after surgical r...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1046/j.1442-2050.2001.00194.x
更新日期:2001-01-01 00:00:00
abstract::Gamma-glutamyltransferase (GGT) is a membrane-bound enzyme involved in the glutathione metabolism. Studies suggested that GGT was a marker of apoptotic balance and modulated tumor progression, invasion and drug resistance. Recently, GGT was shown to be associated with the progression of high-grade esophageal epithelia...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/dote.12227
更新日期:2015-07-01 00:00:00
abstract::The diagnosis of Barrett's esophagus is based on the presence of intestinal metaplasia (IM) at the distal esophagus. The aim of this study was to determine the prevalence of IM in patients with symptoms of gastroesophageal reflux in whom endoscopically a segment of distal esophagus was covered by columnar epithelium (...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1046/j.1442-2050.2003.00284.x
更新日期:2003-01-01 00:00:00
abstract::One of the most common causes of a failed Nissen fundoplication is disruption of the crural repair. We investigated the thickness of the subdiaphragmatic fascia overlying the right and left limb of the right crus in cadavers to determine any difference. Sub-diaphragmatic fascia specimens were obtained from three sites...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2006.00554.x
更新日期:2006-01-01 00:00:00
abstract::Bolus transit through the esophagus has not been validated by videoesophagram in patients with dysphagia and changes in impedance with abnormal barium transit have not been described in those patients. The aim of this study was to compare esophageal impedance findings with barium esophagram measurements in patients wi...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2011.01212.x
更新日期:2012-01-01 00:00:00
abstract::The placement of metal stents is often used as a palliative treatment for malignant esophageal stenosis. We designed a novel stent that has been used clinically since 2011, and we therefore performed a retrospective study to compare the therapeutic effects of this novel metal stent to a conventional partially covered ...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/dote.12446
更新日期:2017-02-01 00:00:00
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journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章,随机对照试验
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abstract:OBJECTIVE:To determine the contribution of mechanical factors to the function of different types of fundoplication. DESIGN AND SETTING:An experimental bench-top study using abattoir-sourced pig esophagus and stomach placed on a tray. Preliminary esophageal myotomy ensured free reflux of 'intragastric fluid'. INTERVEN...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/10.2.110
更新日期:1997-04-01 00:00:00
abstract:SUMMARY:Methylenetetrahydrofolate reductase (MTHFR) and thymidylate synthase (TS) are key enzymes in folate metabolism, which is essential for normal DNA methylation and synthesis. Common polymorphisms at the MTHFR nucleotides position 677 (C-T) and a 28-bp tandem repeat polymorphism (2R or 3R) in the TS promoter enhan...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2005.00492.x
更新日期:2005-01-01 00:00:00
abstract::High body mass index (H-BMI; ≥25 kg/m(2) ) is common in US adults. In a small cohort of esophageal cancer (EC) patients treated with surgery, H-BMI and diagnosis of early stage EC appeared associated. We evaluated a much larger cohort of EC patients. From a prospectively maintained database, we analyzed 925 EC patient...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2011.01290.x
更新日期:2012-09-01 00:00:00
abstract::Hiatal hernia is an underlying factor contributing to gastroesophageal reflux disease (GERD). However, it remains elusive whether the size of the esophageal hiatus has a de facto influence on the lower esophageal sphincter (LES), on the intensity of patient reflux, on GERD symptoms and on the quality of life (QoL). On...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2011.01238.x
更新日期:2012-04-01 00:00:00
abstract::Target volume definition in modern radiotherapy is based on planning computed tomography (CT). So far, 18-fluorodeoxyglucose positron emission tomography (FDG-PET) has not been included in planning modality in volume definition of esophageal cancer. This study evaluates fusion of FDG-PET and CT in patients with esopha...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2009.01044.x
更新日期:2010-08-01 00:00:00
abstract::Esophageal perforation is an uncommon and challenging surgical emergency associated with high rates of morbidity and mortality. At present, no consensus exists on optimal management of the condition. The Pittsburgh Severity Score (PSS) is a tool intended to stratify perforation severity and guide treatment. However, t...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/doy109
更新日期:2019-02-01 00:00:00
abstract::We performed a systematic review of epidemiological, diagnostic, and therapeutic outcomes of esophageal perforations. A systematic review was performed in PubMed database using the key-phrase 'esophageal perforation'. All studies regarding acute esophageal perforations were reviewed and parameters of epidemiology, dia...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章,评审
doi:10.1093/dote/dox013
更新日期:2017-08-01 00:00:00
abstract::This study examines the effects of a proton pump inhibitor on a rat model of duodenogastric reflux. Duodenoesophageal reflux was induced in 60 rats by performing a duodenesophagostomy. The study group received daily intraperitoneal injections of a proton pump inhibitor for 6 months and the control group received an eq...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2001.00145.x
更新日期:2001-01-01 00:00:00
abstract::Achalasia is a disorder of esophageal motility that has been well documented for over 300 years. Despite this, the initiating factor or factors and the underlying mechanisms leading to the characteristic features of achalasia, the absence of distal esophageal peristalsis and abnormal lower esophageal sphincter relaxat...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章,评审
doi:10.1111/j.1442-2050.2006.00569.x
更新日期:2006-01-01 00:00:00
abstract::Megaesophagus is the end-stage of achalasia cardiae. It is the result of peristaltic disorders and slow decompensation of the muscular layer of the esophagus. The aim of this article is to detail the diagnostic criteria and surgical management of megaesophagus. Criteria were acute bending of esophagus axis; lack of es...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1111/j.1442-2050.2008.00897.x
更新日期:2009-01-01 00:00:00
abstract::Esophagectomy is associated with substantial morbidity. Robotic surgery allows complex resections to be performed with potential benefits over conventional techniques. We applied this technology to transthoracic esophagectomy to assess safety, feasibility, and reliability of this technology. A retrospective cohort stu...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/doy005
更新日期:2018-07-01 00:00:00
abstract::Volumetric laser endomicroscopy (VLE) is a balloon-based technique, which provides a circumferential near-microscopic scan of the esophageal wall layers, and has potential to improve Barrett's neoplasia detection. Interpretation of VLE imagery in Barrett's esophagus (BE) however is time-consuming and complex, due to a...
journal_title:Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
pub_type: 杂志文章
doi:10.1093/dote/doz065
更新日期:2020-03-05 00:00:00