Clinical Efficacy of Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction
Background and Study Aims There are a few reports about the efficacy of endoscopic submucosal dissection (ESD) for adenocarcinomas of the esophagogastric junction (EGJ). However, there is no detailed analysis that divides EGJ cancers into Barrett’s adenocarcinoma and gastric cardia adenocarcinoma. T...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2014-03-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1365276 |
| _version_ | 1828486936050794496 |
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| author | Yasuaki Nagami Hirohisa Machida Masatsugu Shiba Tomoko Obayashi Masaki Ominami Shusei Fukunaga Satoshi Sugimori Hirokazu Yamagami Tetsuya Tanigawa Kenji Watanabe Toshio Watanabe Kazunari Tominaga Yasuhiro Fujiwara Tetsuo Arakawa |
| author_facet | Yasuaki Nagami Hirohisa Machida Masatsugu Shiba Tomoko Obayashi Masaki Ominami Shusei Fukunaga Satoshi Sugimori Hirokazu Yamagami Tetsuya Tanigawa Kenji Watanabe Toshio Watanabe Kazunari Tominaga Yasuhiro Fujiwara Tetsuo Arakawa |
| author_sort | Yasuaki Nagami |
| collection | DOAJ |
| description | Background and Study Aims There are a few reports about the efficacy of endoscopic submucosal dissection (ESD) for adenocarcinomas of the esophagogastric junction (EGJ). However, there is no detailed analysis that divides EGJ cancers into Barrett’s adenocarcinoma and gastric cardia adenocarcinoma. The aim of this study was to analyze the efficacy of ESD for EGJ cancers, comparing these two adenocarcinomas.
Patients and Methods This study included 43 patients who underwent ESD for type II EGJ cancers between 2004 and 2011. Pathological examination of resected specimens confirmed 14 cases of Barrett’s adenocarcinoma and 29 cases of gastric cardia adenocarcinoma. Cutting margins on the oral side were placed 1 cm from the squamocolumnar junction, or 1 cm away from the slight elevation that is an endoscopic sign of subsquamous carcinoma extension. Clinical outcomes, prevalence and length of subsquamous carcinoma extension, and long-term outcomes were compared between these two types of adenocarcinoma.
Results No significant differences in clinical outcomes were found between these two types of adenocarcinoma (en bloc, 100 % versus 100 %; complete, 100 % versus 89.7 %; curative, 85.7 % versus 75.9 %). No serious adverse events were encountered. The prevalence of subsquamous carcinoma extension was significantly higher in Barrett’s adenocarcinoma compared with gastric cardia adenocarcinoma. Local and distant recurrence were not observed in any cases with curative resection during the follow-up period (1.6 – 87.6 months).
Conclusion ESD for EGJ cancers, including both Barrett’s adenocarcinoma and gastric cardia adenocarcinoma, was efficient and useful. ESD with a 1 cm safety margin may be acceptable for EGJ cancers. |
| first_indexed | 2024-12-11T09:41:56Z |
| format | Article |
| id | doaj.art-3ec8dc1d921f444293d9c2912a745a30 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-11T09:41:56Z |
| publishDate | 2014-03-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-3ec8dc1d921f444293d9c2912a745a302022-12-22T01:12:39ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362014-03-010201E15E2010.1055/s-0034-1365276Clinical Efficacy of Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric JunctionYasuaki Nagami0Hirohisa Machida1Masatsugu Shiba2Tomoko Obayashi3Masaki Ominami4Shusei Fukunaga5Satoshi Sugimori6Hirokazu Yamagami7Tetsuya Tanigawa8Kenji Watanabe9Toshio Watanabe10Kazunari Tominaga11Yasuhiro Fujiwara12Tetsuo Arakawa13Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, JapanDepartment of Gastroenterology, Machida Gastrointestinal Hospital, Osaka City, JapanDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, JapanDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, JapanDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, JapanDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, JapanDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, JapanDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, JapanDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, JapanDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, JapanDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, JapanDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, JapanDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, JapanDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, JapanBackground and Study Aims There are a few reports about the efficacy of endoscopic submucosal dissection (ESD) for adenocarcinomas of the esophagogastric junction (EGJ). However, there is no detailed analysis that divides EGJ cancers into Barrett’s adenocarcinoma and gastric cardia adenocarcinoma. The aim of this study was to analyze the efficacy of ESD for EGJ cancers, comparing these two adenocarcinomas. Patients and Methods This study included 43 patients who underwent ESD for type II EGJ cancers between 2004 and 2011. Pathological examination of resected specimens confirmed 14 cases of Barrett’s adenocarcinoma and 29 cases of gastric cardia adenocarcinoma. Cutting margins on the oral side were placed 1 cm from the squamocolumnar junction, or 1 cm away from the slight elevation that is an endoscopic sign of subsquamous carcinoma extension. Clinical outcomes, prevalence and length of subsquamous carcinoma extension, and long-term outcomes were compared between these two types of adenocarcinoma. Results No significant differences in clinical outcomes were found between these two types of adenocarcinoma (en bloc, 100 % versus 100 %; complete, 100 % versus 89.7 %; curative, 85.7 % versus 75.9 %). No serious adverse events were encountered. The prevalence of subsquamous carcinoma extension was significantly higher in Barrett’s adenocarcinoma compared with gastric cardia adenocarcinoma. Local and distant recurrence were not observed in any cases with curative resection during the follow-up period (1.6 – 87.6 months). Conclusion ESD for EGJ cancers, including both Barrett’s adenocarcinoma and gastric cardia adenocarcinoma, was efficient and useful. ESD with a 1 cm safety margin may be acceptable for EGJ cancers.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1365276 |
| spellingShingle | Yasuaki Nagami Hirohisa Machida Masatsugu Shiba Tomoko Obayashi Masaki Ominami Shusei Fukunaga Satoshi Sugimori Hirokazu Yamagami Tetsuya Tanigawa Kenji Watanabe Toshio Watanabe Kazunari Tominaga Yasuhiro Fujiwara Tetsuo Arakawa Clinical Efficacy of Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction Endoscopy International Open |
| title | Clinical Efficacy of Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction |
| title_full | Clinical Efficacy of Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction |
| title_fullStr | Clinical Efficacy of Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction |
| title_full_unstemmed | Clinical Efficacy of Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction |
| title_short | Clinical Efficacy of Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction |
| title_sort | clinical efficacy of endoscopic submucosal dissection for adenocarcinomas of the esophagogastric junction |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1365276 |
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