scholarly journals Preoperative Diagnosis and Indications for Endoscopic Resection of Superficial Esophageal Squamous Cell Carcinoma

2020 ◽  
Vol 10 (1) ◽  
pp. 13
Author(s):  
Katsunori Matsueda ◽  
Ryu Ishihara
Keyword(s):  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Endoscopic Resection ◽  
Squamous Cell ◽  
Low Risk ◽  
Lateral Spread ◽  
Muscularis Mucosa ◽  
Minimal Invasiveness

Endoscopic resection (ER) is the mainstay of treatment for superficial esophageal squamous cell carcinoma (SESCC) instead of esophagectomy because of its minimal invasiveness and favorable clinical outcomes. Developments in endoscopic submucosal dissection have enabled en bloc resection of SESCCs regardless of size, thus reducing the risk of local recurrence. Although ER for SESCC is effective, metastasis may subsequently occur. Additionally, extensive esophageal ER confers a risk of postoperative esophageal stricture. Therefore, accurate assessment of the invasion depth and circumferential extent of SESCCs is important in determining the indications for ER. Diagnostic accuracies for SESCC invasion differ between epithelial (EP)/lamina propria (LPM), muscularis mucosa (MM)/submucosal (SM1), and SM2 cancers. ER is strongly indicated for clinically diagnosed (c)EP/LPM cancers because 90% of these are as pathologically diagnosed (p)EP/LPM, which has a very low risk of metastasis. Remarkably, the diagnostic accuracy for cMM/SM1 differs significantly with lateral spread of cancer. Eighty percent of cMM/SM1 cancers with ≤3/4 circumferential spread prove to be pEP/LPM or pMM/SM1, which have very low or low risk of metastasis. Thus, these are adequate candidates for ER. However, given the relatively low proportion of pEP/LPM or pMM/SM1 and high risk of subsequent stricture, ER is not recommended for whole circumferential cMM/SM1 cancers. For cMM/SM1 cancers that involve >3/4 but not the whole circumference, ER should be considered on a lesion-by-lesion basis because the risk of post-ER stricture is not very high, but the proportion of pEP/LPM or pMM/SM1 is relatively low. ER is contraindicated for cSM2 cancers because 75% of them are pSM2, which has high risk of metastasis.

scholarly journals A prognostic model for stratification of stage IB/IIA esophageal squamous cell carcinoma: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lei-Lei Wu ◽  
Qi-Long Ma ◽  
Wei Huang ◽  
Xuan Liu ◽  
Li-Hong Qiu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Prognostic Score ◽  
Training Group ◽  
Low Risk ◽  
Stage Ib ◽  
Ptnm Stage

Abstract Background To explore the postoperative prognosis of esophageal squamous cell carcinoma (ESCC) patients with stage IB/IIA, using a prognostic score (PS). Methods Stage IB/IIA ESCC patients who underwent esophagectomy from 1999 to 2010 were included. We retrospectively recruited 153 patients and extracted their medical records. Moreover, we analyzed the programmed death ligand-1 (PD-L1) expression of their paraffin tissue. The cohort were randomly divided into a training group (N = 123) and a validation group (N = 30). We selected overall survival (OS) as observed endpoint. Prognostic factors with a multivariable two-sided P < 0.05 met standard of covariate inclusion. Results Univariable and multivariable analyses identified pTNM stage, the number of lymph nodes (NLNs) and PD-L1 expression as independent OS predictors. Primary prognostic score which comprised above three covariates adversely related with OS in two cohorts. PS discrimination of OS was comparable between the training and internal validation cohorts (C-index = 0.774 and 0.801, respectively). In addition, the PS system had an advantage over pTNM stage in the identification of high-risk patients (C-index = 0.774 vs. C-index = 0.570, P < 0.001). Based on PS cutoff, training and validation datasets generated low-risk and high-risk groups with different OS. Our three-factor PS predicted OS (low-risk subgroup vs. high-risk subgroup 60-month OS, 74% vs. 23% for training cohort and 83% vs. 45% for validation cohort). Conclusion Our study suggested a PS for significant clinical stratification of IB/IIA ESCC to screen out subgroups with poor prognosis.

A proposal for the management guideline of superficial esophageal squamous cell carcinoma: After endoscopic resection.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 145-145
Author(s):  
Yong Chan Lee ◽  
Jun Chul Park ◽  
Sung Kwan Shin ◽  
Sang Kil Lee ◽  
Hyun Jik Lee
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Lamina Propria ◽  
Endoscopic Resection ◽  
Squamous Cell ◽  
Muscularis Mucosa ◽  
Invasion Depth ◽  
Resection Rate

145 Background: We tried to analyze and deduce a treatment guideline after endoscopic resection of superficial esophageal squamous cell carcinoma in a retrospective analysis. Methods: Medical records of 37 patients who had been treated by endoscopic resection during a 6-year period in single institution were retrospectively analyzed. Results: Mean tumor size was 11.5±5.5 mm (range 3-31). Thirty-one lesions (83.8%) were treated by endoscopic submucosal dissection and 6 lesions by endoscopic mucosal resection (16.2%). En bloc resection rate and complete resection rate was 91.9% and 81.8%, respectively. The tumor invasion depth was diagnosed as epithelium: 5(13.5%), lamina propria mucosa: 12 (32.4%), muscularis mucosa: 10 (27.0%), submucosa: 10 (27.0%) respectively. The lymphovascular invasion was 3 lesions (8.1%). The rates of adverse events were 13.5% including 3 cases (8.1%) of perforation. Ten patients of the invasion depth as muscularis mucosa and submucosa received additional treatments including 6 patients of esophagectomy, 3 patients with radiotherapy and 1 patient with chemoradiotherapy. One patient of lamina propria received radiotherapy due to resection margin positive. The median follow-up duration was 22 month (range, 4-79) and there was no recurrence or metastasis during follow-up. Conclusions: We propose that adequate tailored management strategy after endoscopic resection of superficial esophageal squamous cell carcinoma may provide the favorable clinical results in outcome in treating early stage esophageal carcinoma.

High-Risk and Low-Risk Human Papillomavirus in Esophageal Squamous Cell Carcinoma at Mazandaran, Northern Iran

2012 ◽  
Vol 19 (3) ◽  
pp. 385-391 ◽  
Author(s):  
Y. Yahyapour ◽  
M. Shamsi-Shahrabadi ◽  
M. Mahmoudi ◽  
A. Motevallian ◽  
S. Siadati ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Human Papillomavirus ◽  
High Risk ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Low Risk ◽  
Northern Iran

scholarly journals A Novel Clinical Six-Flavoprotein-Gene Signature Predicts Prognosis in Esophageal Squamous Cell Carcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-13
Author(s):  
Liu Peng ◽  
Jin-Cheng Guo ◽  
Lin Long ◽  
Feng Pan ◽  
Jian-Mei Zhao ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Clinical Significance ◽  
Squamous Cell ◽  
Risk Group ◽  
Gene Signature ◽  
High Risk Group ◽  
Low Risk

Flavoproteins and their interacting proteins play important roles in mitochondrial electron transport, fatty acid degradation, and redox regulation. However, their clinical significance and function in esophageal squamous cell carcinoma (ESCC) are little known. Here, using survival analysis and machine learning, we mined 179 patient expression profiles with ESCC in GSE53625 from the Gene Expression Omnibus (GEO) database and constructed a signature consisting of two flavoprotein genes (GPD2 and PYROXD2) and four flavoprotein interacting protein genes (CTTN, GGH, SRC, and SYNJ2BP). Kaplan–Meier analysis revealed the signature was significantly associated with the survival of ESCC patients (mean survival time: 26.77 months in the high-risk group vs. 54.97 months in the low-risk group, P<0.001, n = 179), and time-dependent ROC analysis demonstrated that the six-gene signature had good predictive ability for six-year survival for ESCC (AUC = 0.86, 95% CI: 0.81–0.90). We then validated its prediction performance in an independent set by RT-PCR (mean survival: 15.73 months in the high-risk group vs. 21.1 months in the low-risk group, P=0.032, n = 121). Furthermore, RNAi-mediated knockdown of genes in the flavoprotein signature led to decreased proliferation and migration of ESCC cells. Taken together, CTTN, GGH, GPD2, PYROXD2, SRC, and SYNJ2BP have an important clinical significance for prognosis of ESCC patients, suggesting they are efficient prognostic markers and potential targets for ESCC therapy.

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