Efficacy and Safety of Endoscopic Resection Followed by Chemoradiotherapy for Superficial Esophageal Squamous Cell Carcinoma: A Retrospective Study

Kenta Hamada; Ryu Ishihara; Yasushi Yamasaki; Noboru Hanaoka; Sachiko Yamamoto; Masamichi Arao; Sho Suzuki; Taro Iwatsubo; Minoru Kato; Yusuke Tonai; Satoki Shichijo; Noriko Matsuura; Hiroko Nakahira; Takashi Kanesaka; Tomofumi Akasaka; Yoji Takeuchi; Koji Higashino; Noriya Uedo; Hiroyasu Iishi; Naoyuki Kanayama; Takero Hirata; Yoshifumi Kawaguchi; Koji Konishi; Teruki Teshima

doi:10.1038/ctg.2017.36

Efficacy and Safety of Endoscopic Resection Followed by Chemoradiotherapy for Superficial Esophageal Squamous Cell Carcinoma: A Retrospective Study

Kenta Hamada, Ryu Ishihara, Yasushi Yamasaki, Noboru Hanaoka, Sachiko Yamamoto, Masamichi Arao, Sho Suzuki, Taro Iwatsubo, Minoru Kato, Yusuke Tonai, Satoki Shichijo, Noriko Matsuura, Hiroko Nakahira, Takashi Kanesaka, Tomofumi Akasaka, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Hiroyasu Iishi, Naoyuki KanayamaTakero Hirata, Yoshifumi Kawaguchi, Koji Konishi, Teruki Teshima

Research output: Contribution to journal › Article › peer-review

28 Citations (Scopus)

Abstract

OBJECTIVES: The reported 1- and 3-year overall survival rates after esophagectomy for stage I superficial esophageal squamous cell carcinoma (SESCC) are 95-97% and 86%, and those after definitive chemoradiotherapy (CRT) are 98% and 89%, respectively. This study was performed to elucidate the efficacy and safety of another treatment option for SESCC: endoscopic resection (ER) followed by CRT.

METHODS: We retrospectively reviewed the overall survival, recurrence, and grade ≥3 adverse events of consecutive patients who refused esophagectomy and underwent ER followed by CRT for SESCC from 1 January 2006 to 31 December 2012.

RESULTS: In total, 66 patients with SESCC underwent ER followed by CRT during the study period, and complete follow-up data were available for all patients. The median age was 67 (range, 45-82) years, and the median observation period was 51 (range, 7-103) months. Local and metastatic recurrences occurred in 2 (3%) and 6 (9%) patients, respectively, and 17 (26%) patients died. The 1-, 3-, and 5-year overall survival rates were 98%, 87%, and 75%, respectively. One of the 23 patients with mucosal cancer and 5 of 43 with submucosal cancer developed metastatic recurrences (P=0.65). Five of the 61 patients with negative vertical resection margin and 1 of 5 with positive vertical resection margin developed metastatic recurrences (P=0.39). None of the 30 patients without lymphovascular involvement developed metastatic recurrences; however, 6 of 36 patients with lymphovascular involvement developed metastatic recurrences (P=0.0098). Grade ≥3 adverse events occurred in 21 (32%) patients and all adverse events were associated with CRT, hematological adverse events in 13 (20%), and non-hematological adverse events in 9 (14%).

CONCLUSIONS: ER followed by CRT provides survival comparable with that of esophagectomy or definitive CRT and has a low local recurrence rate. A particularly favorable outcome is expected for cancers without lymphovascular involvement.

Original language	English
Pages (from-to)	e110
Journal	Clinical and Translational Gastroenterology
Volume	8
Issue number	8
DOIs	https://doi.org/10.1038/ctg.2017.36
Publication status	Published - Aug 3 2017
Externally published	Yes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1038/ctg.2017.36

Cite this

Hamada, K., Ishihara, R., Yamasaki, Y., Hanaoka, N., Yamamoto, S., Arao, M., Suzuki, S., Iwatsubo, T., Kato, M., Tonai, Y., Shichijo, S., Matsuura, N., Nakahira, H., Kanesaka, T., Akasaka, T., Takeuchi, Y., Higashino, K., Uedo, N., Iishi, H., ... Teshima, T. (2017). Efficacy and Safety of Endoscopic Resection Followed by Chemoradiotherapy for Superficial Esophageal Squamous Cell Carcinoma: A Retrospective Study. Clinical and Translational Gastroenterology, 8(8), e110. https://doi.org/10.1038/ctg.2017.36

Hamada, K, Ishihara, R, Yamasaki, Y, Hanaoka, N, Yamamoto, S, Arao, M, Suzuki, S, Iwatsubo, T, Kato, M, Tonai, Y, Shichijo, S, Matsuura, N, Nakahira, H, Kanesaka, T, Akasaka, T, Takeuchi, Y, Higashino, K, Uedo, N, Iishi, H, Kanayama, N, Hirata, T, Kawaguchi, Y, Konishi, K & Teshima, T 2017, 'Efficacy and Safety of Endoscopic Resection Followed by Chemoradiotherapy for Superficial Esophageal Squamous Cell Carcinoma: A Retrospective Study', Clinical and Translational Gastroenterology, vol. 8, no. 8, pp. e110. https://doi.org/10.1038/ctg.2017.36

@article{be93a05bd04d4b14a66152d121941bbd,

title = "Efficacy and Safety of Endoscopic Resection Followed by Chemoradiotherapy for Superficial Esophageal Squamous Cell Carcinoma: A Retrospective Study",

abstract = "OBJECTIVES: The reported 1- and 3-year overall survival rates after esophagectomy for stage I superficial esophageal squamous cell carcinoma (SESCC) are 95-97% and 86%, and those after definitive chemoradiotherapy (CRT) are 98% and 89%, respectively. This study was performed to elucidate the efficacy and safety of another treatment option for SESCC: endoscopic resection (ER) followed by CRT.METHODS: We retrospectively reviewed the overall survival, recurrence, and grade ≥3 adverse events of consecutive patients who refused esophagectomy and underwent ER followed by CRT for SESCC from 1 January 2006 to 31 December 2012.RESULTS: In total, 66 patients with SESCC underwent ER followed by CRT during the study period, and complete follow-up data were available for all patients. The median age was 67 (range, 45-82) years, and the median observation period was 51 (range, 7-103) months. Local and metastatic recurrences occurred in 2 (3%) and 6 (9%) patients, respectively, and 17 (26%) patients died. The 1-, 3-, and 5-year overall survival rates were 98%, 87%, and 75%, respectively. One of the 23 patients with mucosal cancer and 5 of 43 with submucosal cancer developed metastatic recurrences (P=0.65). Five of the 61 patients with negative vertical resection margin and 1 of 5 with positive vertical resection margin developed metastatic recurrences (P=0.39). None of the 30 patients without lymphovascular involvement developed metastatic recurrences; however, 6 of 36 patients with lymphovascular involvement developed metastatic recurrences (P=0.0098). Grade ≥3 adverse events occurred in 21 (32%) patients and all adverse events were associated with CRT, hematological adverse events in 13 (20%), and non-hematological adverse events in 9 (14%).CONCLUSIONS: ER followed by CRT provides survival comparable with that of esophagectomy or definitive CRT and has a low local recurrence rate. A particularly favorable outcome is expected for cancers without lymphovascular involvement.",

author = "Kenta Hamada and Ryu Ishihara and Yasushi Yamasaki and Noboru Hanaoka and Sachiko Yamamoto and Masamichi Arao and Sho Suzuki and Taro Iwatsubo and Minoru Kato and Yusuke Tonai and Satoki Shichijo and Noriko Matsuura and Hiroko Nakahira and Takashi Kanesaka and Tomofumi Akasaka and Yoji Takeuchi and Koji Higashino and Noriya Uedo and Hiroyasu Iishi and Naoyuki Kanayama and Takero Hirata and Yoshifumi Kawaguchi and Koji Konishi and Teruki Teshima",

year = "2017",

month = aug,

day = "3",

doi = "10.1038/ctg.2017.36",

language = "English",

volume = "8",

pages = "e110",

journal = "Clinical and Translational Gastroenterology",

issn = "2155-384X",

publisher = "Nature Publishing Group",

number = "8",

}

TY - JOUR

T1 - Efficacy and Safety of Endoscopic Resection Followed by Chemoradiotherapy for Superficial Esophageal Squamous Cell Carcinoma

T2 - A Retrospective Study

AU - Hamada, Kenta

AU - Ishihara, Ryu

AU - Yamasaki, Yasushi

AU - Hanaoka, Noboru

AU - Yamamoto, Sachiko

AU - Arao, Masamichi

AU - Suzuki, Sho

AU - Iwatsubo, Taro

AU - Kato, Minoru

AU - Tonai, Yusuke

AU - Shichijo, Satoki

AU - Matsuura, Noriko

AU - Nakahira, Hiroko

AU - Kanesaka, Takashi

AU - Akasaka, Tomofumi

AU - Takeuchi, Yoji

AU - Higashino, Koji

AU - Uedo, Noriya

AU - Iishi, Hiroyasu

AU - Kanayama, Naoyuki

AU - Hirata, Takero

AU - Kawaguchi, Yoshifumi

AU - Konishi, Koji

AU - Teshima, Teruki

PY - 2017/8/3

Y1 - 2017/8/3

N2 - OBJECTIVES: The reported 1- and 3-year overall survival rates after esophagectomy for stage I superficial esophageal squamous cell carcinoma (SESCC) are 95-97% and 86%, and those after definitive chemoradiotherapy (CRT) are 98% and 89%, respectively. This study was performed to elucidate the efficacy and safety of another treatment option for SESCC: endoscopic resection (ER) followed by CRT.METHODS: We retrospectively reviewed the overall survival, recurrence, and grade ≥3 adverse events of consecutive patients who refused esophagectomy and underwent ER followed by CRT for SESCC from 1 January 2006 to 31 December 2012.RESULTS: In total, 66 patients with SESCC underwent ER followed by CRT during the study period, and complete follow-up data were available for all patients. The median age was 67 (range, 45-82) years, and the median observation period was 51 (range, 7-103) months. Local and metastatic recurrences occurred in 2 (3%) and 6 (9%) patients, respectively, and 17 (26%) patients died. The 1-, 3-, and 5-year overall survival rates were 98%, 87%, and 75%, respectively. One of the 23 patients with mucosal cancer and 5 of 43 with submucosal cancer developed metastatic recurrences (P=0.65). Five of the 61 patients with negative vertical resection margin and 1 of 5 with positive vertical resection margin developed metastatic recurrences (P=0.39). None of the 30 patients without lymphovascular involvement developed metastatic recurrences; however, 6 of 36 patients with lymphovascular involvement developed metastatic recurrences (P=0.0098). Grade ≥3 adverse events occurred in 21 (32%) patients and all adverse events were associated with CRT, hematological adverse events in 13 (20%), and non-hematological adverse events in 9 (14%).CONCLUSIONS: ER followed by CRT provides survival comparable with that of esophagectomy or definitive CRT and has a low local recurrence rate. A particularly favorable outcome is expected for cancers without lymphovascular involvement.

AB - OBJECTIVES: The reported 1- and 3-year overall survival rates after esophagectomy for stage I superficial esophageal squamous cell carcinoma (SESCC) are 95-97% and 86%, and those after definitive chemoradiotherapy (CRT) are 98% and 89%, respectively. This study was performed to elucidate the efficacy and safety of another treatment option for SESCC: endoscopic resection (ER) followed by CRT.METHODS: We retrospectively reviewed the overall survival, recurrence, and grade ≥3 adverse events of consecutive patients who refused esophagectomy and underwent ER followed by CRT for SESCC from 1 January 2006 to 31 December 2012.RESULTS: In total, 66 patients with SESCC underwent ER followed by CRT during the study period, and complete follow-up data were available for all patients. The median age was 67 (range, 45-82) years, and the median observation period was 51 (range, 7-103) months. Local and metastatic recurrences occurred in 2 (3%) and 6 (9%) patients, respectively, and 17 (26%) patients died. The 1-, 3-, and 5-year overall survival rates were 98%, 87%, and 75%, respectively. One of the 23 patients with mucosal cancer and 5 of 43 with submucosal cancer developed metastatic recurrences (P=0.65). Five of the 61 patients with negative vertical resection margin and 1 of 5 with positive vertical resection margin developed metastatic recurrences (P=0.39). None of the 30 patients without lymphovascular involvement developed metastatic recurrences; however, 6 of 36 patients with lymphovascular involvement developed metastatic recurrences (P=0.0098). Grade ≥3 adverse events occurred in 21 (32%) patients and all adverse events were associated with CRT, hematological adverse events in 13 (20%), and non-hematological adverse events in 9 (14%).CONCLUSIONS: ER followed by CRT provides survival comparable with that of esophagectomy or definitive CRT and has a low local recurrence rate. A particularly favorable outcome is expected for cancers without lymphovascular involvement.

U2 - 10.1038/ctg.2017.36

DO - 10.1038/ctg.2017.36

M3 - Article

C2 - 28771241

SN - 2155-384X

VL - 8

SP - e110

JO - Clinical and Translational Gastroenterology

JF - Clinical and Translational Gastroenterology

IS - 8

ER -

Efficacy and Safety of Endoscopic Resection Followed by Chemoradiotherapy for Superficial Esophageal Squamous Cell Carcinoma: A Retrospective Study

Abstract

UN SDGs

Access to Document

Fingerprint

Cite this