Outcomes of endoscopic submucosal dissection for early esophageal and gastric cardia adenocarcinomas - 14/05/21
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| pages | 10 |
| Iconographies | 2 |
| Vidéos | 0 |
| Autres | 0 |
Highlights |
• | ESD is a safe treatment for early esophagogastric junction adenocarcinomas. |
• | In Western countries, the resection is curative in two-thirds of the patients. |
• | ESD should be considered for routine resection of esophageal adenocarcinomas. |
Abstract |
Objectives |
Adenocarcinomas of the esophagus and of the gastric cardia are regarded as a same clinical entity in oncology. For endoscopic resection however, endoscopic mucosal resection is recommended for esophageal adenocarcinoma, while endoscopic submucosal dissection (ESD) is advocated for gastric adenocarcinomas. Our aim was to compare the outcomes of ESD in both types of esophagogastric junction adenocarcinomas.
Methods |
Between March 2015 and December 2019, we included all patients who underwent an ESD for early adenocarcinoma of the esophagogastric junction at a French tertiary referral center. Esophageal and gastric cardia adenocarcinomas were compared in terms of clinical, procedural and histological outcomes.
Results |
57 esophageal and 19 gastric cardia adenocarcinomas were included in the analysis, for a total of 76 patients. The median (IQR) size of the resections was 40 (40–57.5) and 50 (35–55)mm, p=0.96, respectively. En bloc resection was achieved in 100% and 89% for adenocarcinomas of the esophagus and the gastric cardia, p=0.06. Late adverse events occurred in 14% and 5.3%, respectively, p=0.44, with no severe adverse event. Curative resection rates were 67% and 63% for adenocarcinomas of the esophagus and the gastric cardia, respectively, p=0.89.
Conclusion |
ESD is a safe treatment for T1 adenocarcinomas of the esophagogastric junction, curative in two thirds of the patients, in tumors arising from the esophagus or from the stomach. ESD should be considered for the routine resection of esophageal adenocarcinomas.
Le texte complet de cet article est disponible en PDF.Keywords : Endoscopic submucosal dissection, Barrett's esophagus, Early gastric neoplasia, Esophagogastric junction adenocarcinoma
Plan
Vol 45 - N° 3
Article 101700- mai 2021 Retour au numéro
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