Clinical Gastroenterology Vol.23 No.1(3)

Theme Therapeutic Strategy for Early Gastrointestinal Cancers with EMR or ESD
Title Efficacy of EMR for Treatment of Early Esophageal Cancer
Publish Date 2008/01
Author Hiroki Kawai Department of Endoscopy, Aichi Cancer Center Hospital
Author Masahiro Tajika Department of Endoscopy, Aichi Cancer Center Hospital
Author Reiko Takayama Department of Gastroenterology, Aichi Cancer Center Hospital
Author Yohei Takeda Department of Gastroenterology, Aichi Cancer Center Hospital
Author Tsuneya Nakamura Department of Endoscopy, Aichi Cancer Center Hospital
[ Summary ] Recently, endoscopic submucosal dissection (ESD) has been applied to the treatment of early esophageal cancer. We have treated early esophageal cancer with endoscopic mucosal resection (EMR) since 1993. The percentages of locoregional recurrence and lymph node metastasis were 0.7 % (1 / 151 lesions) and 0 %, respectively, in lesions whose invasive depth was limited to the mucosal epithelium or the lamina propria mucosa. In contrast, the figures were 12.5 % (5 / 40 lesions) and 5 % (2 / 38 cases) respectively, for lesions which had invaded the muscularis mucosa or the superficial part of the submucosa. There were 0 % (0 / 6 lesions) and 16.7 % (1 / 6 cases) respectively, in which the lesions had invaded the middle part of the submucosa. EMR was evaluated as an effective treatment procedure for early esophageal cancer, with an invasive depth limited to the lamina propria mucosa. However, further investigation is needed into the indications for ESD and additional treatment for esophageal cancer which has invaded the muscularis mucosae or deeper.
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