Endoscopic Resection of Residual or Recurrent Lesions after Circumferential Radiofrequency Ablation for Flat Superficial Esophageal Squamous Cell Neoplasias
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Selection
2.2. Radiofrequency Ablation
2.3. Endoscopic Resection
2.4. Control Group
2.5. Statistical Analyses
3. Results
3.1. Index Radiofrequency Ablation
3.2. Endoscopic Resection
3.3. Pathological Results of the Resected Specimens
3.3.1. Neoplasia Extension to Ducts and Submucosal Glands
3.3.2. Three Pathological Groups
3.4. Results of Post-RFA ESD Versus Primary ESD
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient Characteristics (n = 11) | Number (%), or Median (Range) |
---|---|
Age, years | 55 (40–69) |
Sex, male | 11 (100%) |
Underlying disease | |
Hypertension | 1 (9.1%) |
Liver cirrhosis | 5 (45.5%) |
Hepatocellular carcinoma | 3 (27.3%) |
Synchronous head and neck cancer | 3 (27.3%) |
Chronic pancreatitis | 1 (9.1%) |
Any ER before RFA | 4 (36.4%) |
Length of tumor area †, mm | 160 (60–180) |
Length of index RFA, mm | 180 (70–240) |
Esophageal stricture after index RFA | 2 ‡ (18.2%) |
Additional RFA required after index RFA | 2 (18.2%) |
Tumor Characteristics (n = 17) | Number (%), or Median (Range) |
---|---|
Residual SESCN after index RFA | 8 (47.1%) |
Recurrent SESCN after index RFA | 9 (52.9%) |
Time between index RFA and ER, months | |
For residual SESCN (n = 8) | 4.3 (2.8–5.6) |
For recurrent SESCN (n = 9) | 13.0 (11.8–28.5) |
Tumor length, mm | 25 (10–66) |
Of residual SESCN (n = 8) | 35 (10–66) |
Of recurrent SESCN (n = 9) | 23 (18–46) |
ER method | |
ESD | 14 † (82.4%) |
EMR | 3 ‡ (17.6%) |
Pathologic results after ER (n = 16) * | |
Duct/SMG involvement | 8 (50%) |
Of HGIN (n = 10) | 4 (40%) |
Of SCC (n = 6) | 4 (66.7%) |
Of residual SESCN (n = 7) * | 5 (71.4%) |
Of recurrent SESCN (n = 9) | 3 (33.3%) |
HGIN without duct/SMG involvement | 6 (37.5%) |
HGIN with duct/SMG involvement | 4 (25.0%) |
SCC | 6 (37.5%) |
Post-RFA ESD (n = 14) | Primary ESD (n = 74) | p-Value | |
---|---|---|---|
Age | 53 (41–69) | 59 (40–82) | 0.064 |
Tumor length (mm) | 29 (18–66) | 35 (18–67) | 0.222 |
Procedure time, min | 53 (25–340) | 110 (26–315) | 0.09 |
Dissection speed, mm2/min | 7.0 (4.4–20.6) | 8.6 (2.1–54.8) | 0.644 |
En bloc resection, n (%) | 14 (100%) | 74 (100%) | - |
Completeness of resection | 1 | ||
R0, n (%) | 12 (85.7%) | 65 (87.8%) | |
R1, n (%) | 2 † (14.3%) | 9 ‡ (12.2%) | |
Complications | |||
Significant bleeding, n (%) | 1 (7.1%) | 0 | 0.159 |
Perforation, n (%) | 0 | 0 | - |
Esophageal stricture after ESD, n (%) | 1 (7.1%) | 22 (29.7%) | 0.102 |
Tumor invasion depth | 0.435 | ||
HIGN, n (%) | 8 (57.1%) | 28 (37.8%) | 0.178 |
T1a-m2, n (%) | 0 | 10 (13.5%) | 0.353 |
T1a-m3, n (%) | 3 (21.4%) | 12 (16.2%) | 0.700 |
T1b-sm1, n (%) | 1 (7.1%) | 5 (6.8%) | 1 |
T1b-sm2, n (%) | 2 (14.3%) | 19 (25.7%) | 0.504 |
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Tsou, Y.-K.; Yeh, C.-J.; Le, P.-H.; Chen, B.-H.; Lin, C.-H. Endoscopic Resection of Residual or Recurrent Lesions after Circumferential Radiofrequency Ablation for Flat Superficial Esophageal Squamous Cell Neoplasias. Cancers 2023, 15, 3558. https://doi.org/10.3390/cancers15143558
Tsou Y-K, Yeh C-J, Le P-H, Chen B-H, Lin C-H. Endoscopic Resection of Residual or Recurrent Lesions after Circumferential Radiofrequency Ablation for Flat Superficial Esophageal Squamous Cell Neoplasias. Cancers. 2023; 15(14):3558. https://doi.org/10.3390/cancers15143558
Chicago/Turabian StyleTsou, Yung-Kuan, Chi-Ju Yeh, Puo-Hsien Le, Bo-Huan Chen, and Cheng-Hui Lin. 2023. "Endoscopic Resection of Residual or Recurrent Lesions after Circumferential Radiofrequency Ablation for Flat Superficial Esophageal Squamous Cell Neoplasias" Cancers 15, no. 14: 3558. https://doi.org/10.3390/cancers15143558