Journal Article

Endoscopic mucosal resection for gastroesophageal cancer in a U.K. population. Long-term follow-up of a consecutive series

Crumley, Andrew B. C., Stuart, Robert C., Shearer, Christopher J., McEwan, Kerryanne, Stanley, Adrian J., Going, James J., Abela, Jo-Etienne, McKernan, Margaret

2011

Overview

Background Endoscopic mucosal resection (EMR) of early gastric and esophageal tumors is effective and avoids the morbidity and mortality of surgery. We report the long-term results of a consecutive series of 93 endoscopic resections, during a 7-year period, in a U.K. population. Methods Eighty-eight patients with 93 lesions were included. EMR was performed for 64 and 29 malignant and benign lesions, respectively. Patients with malignant disease were subgrouped into “high risk” or “low risk” for recurrence. Results Of the 35 lesions in the low-risk group, local control was achieved in 31; 29 after 1 EMR session. Two had residual invasive carcinoma, one had treatment ceased due to pancreatic cancer, and one patient did not attend follow-up. Of the 29 lesions in the high-risk group, local control was achieved in 15; 13 after 1 EMR session. Median follow-up was 53 months. Cancer specific survival for the 45 invasive cancers (T1m and T1sm) was 93%; three patients died from their disease. Conclusions This study has shown for the first time in a U.K. population that EMR is effective in controlling disease in patients with local high grade dysplasia (HGD) and early invasive carcinoma, with no mortality and low morbidity.

• Publisher: Springer-Verlag,Springer,Springer Nature B.V
• Subject: Abdominal Surgery / Age Factors / Aged / Aged, 80 and over / Biological and medical sciences / Biopsy / Cancer / Cohort Studies / Endoscopy / Esophageal Neoplasms - mortality / Esophageal Neoplasms - pathology / Esophageal Neoplasms - surgery / Esophagogastric Junction - pathology / Esophagogastric Junction - surgery / Esophagoscopy - adverse effects / Esophagoscopy - methods / Esophagus / Female / Follow-Up Studies / Gastric Mucosa - pathology / Gastric Mucosa - surgery / Gastroenterology / Gastroenterology. Liver. Pancreas. Abdomen / Gastroscopy - adverse effects / Gastroscopy - methods / Gynecology / Hepatology / Humans / Male / Medical sciences / Medicine / Medicine & Public Health / Middle Aged / Morbidity / Mortality / Mucous Membrane - pathology / Mucous Membrane - surgery / Neoplasm Recurrence, Local - mortality / Neoplasm Recurrence, Local - pathology / Neoplasm Recurrence, Local - surgery / Neoplasm Staging / Postoperative Complications - mortality / Postoperative Complications - physiopathology / Proctology / Retrospective Studies / Risk Assessment / Sex Factors / Stomach Neoplasms - mortality / Stomach Neoplasms - pathology / Stomach Neoplasms - surgery / Stomach, duodenum, intestine, rectum, anus / Stomach. Duodenum. Small intestine. Colon. Rectum. Anus / Surgeons / Surgery / Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases / Surgery of the digestive system / Survival Analysis / Time Factors / Treatment Outcome / Tumors / United Kingdom