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- Title
Prognostic Benefit of Additional Treatment After Endoscopic Submucosal Dissection for Esophageal Squamous Cell Carcinoma.
- Authors
Takahashi, So; Hatta, Waku; Watanabe, Kenta; Koike, Tomoyuki; Shimada, Tomohiro; Hikichi, Takuto; Toya, Yosuke; Tanaka, Ippei; Onozato, Yusuke; Hamada, Koichi; Fukushi, Daisuke; Watanabe, Ko; Kayaba, Shoichi; Ito, Hirotaka; Mikami, Tatsuya; Oikawa, Tomoyuki; Takahashi, Yasushi; Kondo, Yutaka; Yoshimura, Tetsuro; Shiroki, Takeharu
- Abstract
Background: Although additional treatment is considered for patients with esophageal squamous cell carcinoma (ESCC) invading into the muscularis mucosa (pT1a-MM) or submucosa (pT1b-SM) after endoscopic submucosal dissection (ESD), the actual benefits of this method remain to be elucidated. Aims: We aimed to evaluate the prognostic benefits of additional treatment in such patients. Methods: Between 2006 and 2017, we enrolled patients with pT1a-MM/pT1b-SM ESCC after ESD at 21 institutions in Japan. Overall survival (OS) and disease-specific survival (DSS) were compared between the additional treatment and follow-up groups after propensity score matching, to reduce the bias of baseline characteristics. A subgroup analysis was performed according to the pathological findings: category A, pT1a-MM but negative for lymphovascular invasion (LVI) and vertical margin (VM); category B, tumor invasion into the submucosa ≤ 200 μm but negative for LVI and VM; category C, others. Results: Of 593 patients with pT1a-MM/pT1b-SM ESCC after ESD, 101 matched pairs were extracted after propensity score matching. The OSs were similar between the additional treatment and follow-up groups (80.6% vs. 78.6% in 5 years; P = 0.972). In a subgroup analysis, the OS in the additional treatment group was significantly lower than that in the follow-up group (65.7% vs. 95.2% in 5 years; P = 0.037) in category A, whereas OS did not significantly differ in category C (76.8% vs. 69.5% in 5 years; P = 0.360). Conclusions: Additional treatment after ESD in patients with pT1a-MM/pT1b-SM ESCC was not associated with an improved prognosis.
- Subjects
JAPAN; ESOPHAGEAL cancer; SQUAMOUS cell carcinoma; PROPENSITY score matching; OVERALL survival; DISSECTION
- Publication
Digestive Diseases & Sciences, 2023, Vol 68, Issue 5, p2050
- ISSN
0163-2116
- Publication type
Article
- DOI
10.1007/s10620-022-07746-8