Endoscopic mucosal resection for squamous premalignant and early malignant lesions of the esophagus.
BACK AND STUDY AIMS: Endoscopic mucosal resection (EMR) is used to treat premalignant and malignant digestive tract lesions. This report presents the efficacy and safety of EMR for squamous superficial neoplastic esophageal lesions.


METHODS
A retrospective cohort study presented data from 51 patients with 54 lesions over an 8-year period, between November 1997 and September 2005. Dysplasas or mucosal (m) T1 carcinomas were treated with repeated EMR until there was a complete local remission. Patients with submucosal (sm) T1 carcinomas were treated with repeated EMR until there was a complete local remission. Patients with submucosal (sm) T1 carcinomas or more advanced stage were offered surgery or chemoradiotherapy.


RESULTS
There was no mortality, perforation, or major hemorrhage, and there were three easily dilated stenoses. Of the patients, 16 had lesions graded as T1sm or more advanced and one patient was found to have normal tissue post EMR. Complete local remission was achieved in 31 of the 34 patients with dysplasia or T1 m cancers (91%). There was no distant relapse and there was local disease recurrence in eight of the 31 patients (26%). The 5-year survival rate was 95%.


CONCLUSIONS
EMR for squamous superficial neoplastic lesions of the esophagus is safe and provides satisfactory survival results.
Ciocirlan
M
M
Gastroenterology and Hepatology Centre, Fundeni Clinical Institute, Bucharest, Romania. ciocirlanm@yahoo.com
Lapalus
M G
MG
Hervieu
V
V
Souquet
J C
JC
Napoléon
B
B
Scoazec
J Y
JY
Lefort
C
C
Saurin
J C
JC
Ponchon
T
T
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000473:pathology / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000601:surgery*; D009367:Neoplasm Staging; D011230:Precancerous Conditions / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies