Adjuvant therapy for pT1a-m3/pT1b esophageal squamous cell carcinoma after endoscopic resection: Esophagectomy or chemoradiotherapy? A critical review

被引:27
作者
Tsou, Yung-Kuan [1 ]
Lee, Cheng-Han [1 ,2 ]
Le, Puo-Hsien [1 ,2 ]
Chen, Bo-Huan [1 ,2 ]
机构
[1] Chang Gung Mem Hosp, Dept Gastroenterol & Hepatol, 5 Fu Shin St, Taoyuan 333, Taiwan
[2] Chang Gung Univ, Coll Med, Taoyuan, Taiwan
关键词
Endoscopic resection; Endoscopic submucosal dissection; Adjuvant therapy; Esophagectomy; Chemoradiotherapy; Superficial esophageal cancer; SUBMUCOSAL DISSECTION; SURGICAL RESECTION; MUCOSAL RESECTION; MAJOR MORBIDITY; CANCER; RISK; PREVALENCE; PREDICTORS; MORTALITY; NEOPLASMS;
D O I
10.1016/j.critrevonc.2020.102883
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Endoscopic resection (ER) combined with adjuvant therapy appears to be a new treatment for esophageal squamous cell cancers (ESCC) invading to deep mucosa (pT1a-m3) or submucosa (pu1b). Adjuvant therapy can take the form of esophagectomy or chemoradiotherapy (CRT), but it is unclear which treatment is better. This review is to explore the outcomes of adjuvant therapy between esophagectomy and CRT for the treatment of pT1a-m3/pT1b ESCC after ER. Ten relevant studies with a total of 285 patients were included. The reported 5year overall survival rates ranged between 90-100 % for ER-esophagectomy and 75-85 % for ER-CRT. ESCC with the invasion of >= sm2 combined with lymphovascular involvement was associated with a high-risk of relapse in patients receiving ER-CRT, but not in ER-esophagectomy. In conclusion, patients with a high-risk of relapse should be treated with ER-esophagectomy; ER-CRT may be used as an alternative treatment for patients with a nonhigh risk of relapse.
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页数:7
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