Clinicopathological examination of ESD as salvage therapy for esophageal cancer after definitive chemo-radiation therapy

• Published in: Endoscopy International Open 2018-04, Vol.6 (4), p.E450-E461
• Main Authors: Kagawa, Tomo, Ishikawa, Shigenao, Inaba, Tomoki, Colvin, Mariko, Toyosawa, Junki, Aoyama, Yuki, Ishida, Masaya, Kuraoka, Sakiko, Okamoto, Kunio, Sakakihara, Ichiro, Izumikawa, Koichi, Yamamoto, Kumiko, Takahashi, Sakuma, Tanaka, Shigetomi, Matsuura, Mihoko, Hasui, Toshimi, Wato, Masaki, Ando, Midori, Nakamura, Satoko, Mizobuchi, Koichi
• Format: Article
• Language: English
• Subjects: Original article
• ISSN: 2364-3722; 2196-9736
• DOI: 10.1055/s-0044-102296

Abstract Background and study aims  Salvage therapy for esophageal cancer following chemo-radiation therapy (CRT) has not been established. We aimed to evaluate endoscopic submucosal dissection (ESD) as a salvage therapy based on histopathological features of lesions. Patients and methods  We compared 10 lesions in eight patients with local residual, recurrent, or metachronous esophageal squamous cell carcinoma treated by ESD after CRT (CRT group) and 59 lesions treated by ESD without CRT (non-CRT group) during the same period. Results  The en bloc resection rate was 100 % while the complete resection rate was 80.0 % in the lesions after CRT, indicating no difference between the CRT and non-CRT groups. Pathological examination showed that fibrosis was more intense in the lamina propria mucosa, muscularis mucosa, and submucosa. The muscularis mucosa was thicker in both non-tumor and tumor sites in the CRT group compared to the non-CRT group. However, severe submucosal fibrosis was observed only in one lesion in the CRT group. The maximum diameter of the submucosal artery was significantly larger in the CRT group ( P