Clinical Outcomes of Esophagectomy and Chemoradiotherapy After Endoscopic Resection for Superficial Esophageal Squamous Cell Carcinoma

Abstract

Background/Aim: Surgical resection and chemoradiotherapy (CRT) can be performed as additional treatments for superficial esophageal cancer after endoscopic resection, but the selection criteria vary depending on the institution. We retrospectively evaluated the outcomes of patients with endoscopically resected superficial esophageal cancer treated with surgical resection and CRT at our institution. Patients and Methods: The outcomes of 67 cases of additional treatment after endoscopic resection of superficial esophageal cancer, excluding adenocarcinoma, performed at our hospital from January 2000 to June 2017 were compared (30 cases in the surgery group and 37 cases in the CRT group). Results: In the surgery group, eight patients had lymph node metastasis and two had recurrence in the supraclavicular fossa lymph nodes after surgery, therefore reoperation was performed. There were no deaths from esophageal cancer, and the 5-year survival rate was 92.6%. One patient in the CRT group had a recurrence in the cervical paraoesophageal lymph node, which was resected, but no death from esophageal cancer was observed, and the 5-year survival rate was 81.0%. The 5-year survival rate was significantly better in the surgery group than in the CRT group (p=0.039). The greater number of elderly patients in the CRT group was considered to be the reason for the worse prognosis, Conclusion: Although the prognosis of esophagectomy or chemoradiotherapy (CRT) is very favorable, CRT is considered to be the preferred additional treatment after endoscopic resection of superficial esophageal cancer without lymph node metastasis from the viewpoint of organ preservation.