Zhang YQ, et al. - An inquiry was set up with regard to the consequences of endoscopic submucosal dissection (ESD) for superficial proximal esophageal neoplasia. It was deduced that ESD was a safe and a very effective treatment option for the superficial proximal esophageal neoplasia. It displayed a 100% 5-year disease-specific survival rate.

Methods

• Researchers enrolled 102 consecutive patients with 106 lesions who underwent ESD from February 2009 to July 2015 at the Zhongshan Hospital, Fudan University in Shanghai, China.
• They gauged the en bloc and pathologically complete resection rates, complication rate, incidence of esophageal stricture after ESD, disease-specific, and overall survival rates.

Results

• Herein, the mean age was 62 (45-84) years with 100% en bloc resection rate.
• The mean operation time was 48 (10-144) minutes. It was noted that the mean diameter of the resected tumors was 2.9 (1.2-6.5) cm.
• The pathological diagnoses were discovered to be high-grade intraepithelial dysplasia in 45 (42.5%) lesions, and the rest were squamous cell carcinoma with staging of intraepithelial in 18 (17.0%), lamina propria in 13 (12.3%), muscularis mucosa in 16 (15.1%), SM1 in 10 (9.4%), and SM2 or deeper in 4 (3.8%) of the lesions.
• The R0 resection rates were 94.3% (100/106).
• No delayed bleeding occurred.
• Findings revealed successful closure of two small perforations with clips.
• Symptomatic esophageal strictures in 17 (16.7%) patients underwent treatment via endoscopic balloon dilation with a mean of 4 (1-14) times and 88.2% (15/17) success.
• The yielded data suggested further treatments of esophagectomy or chemoradiotherapy for patients with SM1 or deeper neoplasia or incomplete resection.
• Three cases (2.9%) reported local recurrence.
• Fifteen patients were lost to follow-up.
• Five-year overall survival rate was discovered to be 98% and disease-specific survival rate was 100%.
• The mean follow-up time was determined to be 33.6 months.