title: Photodynamic therapy for large superficial squamous cell carcinoma of the esophagus.
abstract: BACKGROUND
  Photodynamic therapy (PDT) has been found to be safe and effective in patients with small early esophageal squamous cell carcinoma (SCC). However, its efficacy for widespread superficial SCC has not yet been confirmed.
  
  
  OBJECTIVE
  To assess the long-term survival, complications, and recurrence of PDT for large superficial esophageal SCC.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  A total of 38 patients with superficial SCC of the esophagus. All patients had a large unifocal lesion or multifocal lesions that were too large to be resected endoscopically. In addition, all patients were physiologically unfit for esophagectomy or had refused surgery.
  
  
  METHODS
  PDT with porfimer sodium.
  
  
  METHODS
  Clinical follow-up, long-term survival, complications, and recurrence were evaluated.
  
  
  RESULTS
  Thirty-one patients (82%) had mucosal cancer (T1m), and 7 (18%) had submucosal cancer (T1sm). No patient had lymph node involvement. Nineteen patients had other primary malignancies. Complete remission was achieved in 33 (87%). At the time of writing, 28 patients (74%) were alive without recurrence. After a median follow-up period of 64 months (range, 7-125 months) after PDT, the overall 5-year survival rate was 76%. There was no treatment-related mortality.
  
  
  CONCLUSIONS
  Retrospective study with a small number of patients.
  
  
  CONCLUSIONS
  This long-term follow-up study revealed that PDT was a potentially curative treatment for large superficial esophageal SCC. PDT might be a reasonable alternative to esophagectomy or to endoscopic resection for patients with superficial SCC of the esophagus without lymph node metastasis.
authors.affiliation: Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Tanaka
authors.forename: Satoru
authors.initials: S
authors.lastname: Matono
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagano
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Murata
authors.forename: Susumu
authors.initials: S
authors.lastname: Sueyoshi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yamana
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shirouzu
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Fujita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology; D017323:Dihematoporphyrin Ether / Q000627:therapeutic use*; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D017323:Dihematoporphyrin Ether