title: Outcomes of T1b esophageal adenocarcinoma patients.
abstract: BACKGROUND
  Esophagectomy is usually recommended for patients with submucosal esophageal adenocarcinoma (T1b EAC) because of the potential for lymph node metastasis (LNM). Endoscopic management often differs based on the risk of metastasis. There is limited information on the difference in outcomes for T1b-EAC with and without esophagectomy.
  
  
  OBJECTIVE
  To investigate (1) the outcomes of T1b EAC treatments with and without esophagectomy and (2) the percentage of LNM at esophagectomy for T1b-EAC.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  A tertiary Barrett's esophagus unit.
  
  
  METHODS
  Sixty-eight T1b EAC patients based on EMR histology.
  
  
  METHODS
  Esophagectomy and endoscopic therapies.
  
  
  METHODS
  Survival duration and mortality rate.
  
  
  RESULTS
  A total of 68 patients had T1b EAC; cumulative mortality rate was 30.9% and median survival duration was 39.5 months. Thirty-nine underwent esophagectomy and 29 did not. Among patients who underwent esophagectomy, 13 (33.3%) had LNM, and the mortality rate was 50.0% and 11.1% for those with and without LNM, respectively (P < .01). For those with and without esophagectomy, the cumulative mortality rates were 25.6% and 37.9%, and median survival duration was 48.9 and 34.8 months, respectively. There was no statistical difference in Charlson comorbidity index, number of EMRs, mortality rate, or survival duration. In Cox proportional hazard model analysis, the hazard ratio for esophagectomy was 0.5 (P = .21).
  
  
  CONCLUSIONS
  Retrospective, nonrandomized small sample size cohort.
  
  
  CONCLUSIONS
  Among the patients with T1b EAC found in EMR specimens who underwent esophagectomy, one third had regional LNM. In our small series, patients who underwent esophagectomy did not have a significantly different survival duration from that of those who did not, indicating that these patients may have similar outcomes [corrected].
authors: Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
authors: Jianmin
authors: J
authors: Tian
authors: Ganapathy A
authors: GA
authors: Prasad
authors: Lori S
authors: LS
authors: Lutzke
authors: Jason T
authors: JT
authors: Lewis
authors: Kenneth K
authors: KK
authors: Wang
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000628:therapy; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D019160:Endosonography; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents