Management of Clinical T1N0M0 Esophageal Cancer.

Andrew J. Yang; Seo Hee Choi; Hwa Kyung Byun; Hyun Ju Kim; Jinhyun Choi; Yong Chan Lee; Sang Kil Lee; Kyung Ran Park; Chang Geol Lee

Background/Aims: Endoscopic resection is a standard treatment for stage T1a esophageal cancer, with esophagec-tomy or radical radiation therapy (RT) performed for stage T1b lesions. This study aimed to compare treatment out-comes of each modality for clinical stage T1 esophageal can-cer. Methods: In total, 179 patients with clinical T1N0M0-stage esophageal cancer treated from 2006 to 2016 were retrospectively evaluated. Sixty-two patients with clinical T1a-stage cancer underwent endoscopic resection. Among 117 patients with clinical T1b-stage cancer, 82 underwent esoph-agectomy, and 35 received chemoradiotherapy or RT. We compared overall survival (OS) and recurrence-free survival (RFS) rates for each treatment modality. Results: The medi-an follow-up time was 32 months (range, 1 to 120 months). The 5-year OS and RFS rates for patients with stage T1a cancer receiving endoscopic resection were 100% and 85%, respectively. For patients with stage T1b, the 5-year OS and RFS rates were 78% and 77%, respectively, for the esopha-gectomy group; 80% and 44%, respectively, for the RT alone group; and 96% and 80%, respectively, for the chemoradia-tion group. The esophagectomy group showed significantly higher RFS than the RT alone group (p=0.04). There was no significant difference in RFS between the esophagectomy and chemoradiation groups (p=0.922). Grade 4 or higher treatment-related complications occurred in four patients who underwent esophagectomy. Conclusions: Endoscopic resection appeared to be an adequate treatment for patients with T1a-stage esophageal cancer. The multidisciplinary approach involving chemoradiation was comparable to esophagectomy in terms of survival outcome without serious complications for T1b-stage esophageal cancer.

ESOPHAGEAL cancer; THERAPEUTICS; ESOPHAGEAL cancer patients; RADIOTHERAPY; DISEASE complications

Gut & Liver, 2019, Vol 13, Issue 3, p315

1976-2283

Academic Journal

10.5009/gnl18254