Dr Esaki and colleagues from Japan elucidated the risk factors for local recurrence after endoscopic mucosal resection for superficial esophageal cancer.
The research team performed a retrospective analysis of the clinical course of 62 patients with 64 superficial esophageal cancers.
The patients were treated by endoscopic mucosal resection between 1993 and 2004.
Follow-up examinations by chromoscopy with iodine solution and biopsy were performed at 3 months, 6 months, 12 months.
|Piecemeal resection did not increase recurrence risk|
Chromoscopy was then repeated annually after endoscopic mucosal resection.
The team defined local recurrence as a histologically confirmed finding of cancer cells at the site of the preceding endoscopic mucosal resection.
The researchers retrospectively analyzed contributions of lesion-related and procedure-related factors to local recurrence.
The researchers detected local recurrence in 14 of 64 superficial esophageal cancers 3 to 36 months after endoscopic mucosal resection.
Of the lesion-related factors assessed, the team found local recurrence to be more frequent in superficial esophageal cancers with a larger diameter.
The team noted that larger circumferential spread, or deeper invasion were both more frequent in superficial esophageal cancers.
However, the team noted that the last 2 factors failed to demonstrate statistical significance after correction for multiple testing.
Piecemeal resection did not increase the risk of local recurrence.
The researchers observed that the need for adjunctive coagulation therapy increased the risk of local recurrence.
Dr Esaki's team concludes, “Larger superficial esophageal cancers are associated with a higher risk of local recurrence after endoscopic mucosal resection.”
“In patients with residual lesions, coagulation therapy does not seem to be adequate as additional endoscopic treatment.”