Published online Mar 21, 2021. doi: 10.3748/wjg.v27.i11.1043
Peer-review started: November 7, 2020
First decision: January 23, 2021
Revised: January 27, 2021
Accepted: March 7, 2021
Article in press: March 7, 2021
Published online: March 21, 2021
Recent improvements in the prognosis of patients with esophageal cancer have led to the increased occurrence of gastric tube cancer (GTC) in the reconstructed gastric tube.
There are few reports on the treatment results of endoscopic submucosal dissection (ESD) for GTC.
This retrospective study aimed to evaluate the efficacy and safety of ESD for GTC after esophagectomy in a multicenter trial.
We retrospectively investigated 48 GTC lesions in 38 consecutive patients with GTC in the reconstructed gastric tube after esophagectomy who had undergone ESD between January 2005 and December 2019 at 8 institutions participating in the Okayama Gut Study group. Patient characteristics, treatment results, clinical course, and treatment outcomes were analyzed.
The median age of patients was 71.5 years (range, 57-84years), and there were 34 men and 4 women. The median observation period after ESD was 884 d (range, 8-4040 d). The median procedure time was 81 min (range, 29-334 min), the en bloc resection rate was 91.7% (44/48), and the curative resection rate was 79% (38/48). Complications during ESD were seen in 4% (2/48) of case, and those after ESD were seen in 10% (5/48) of case. The survival rate at 5 years was 59.5%. During the observation period after ESD, 10 patients died of other diseases. Although there were differences in the procedure time between institutions, a multivariate analysis showed that tumor size was the only factor associated with prolonged procedure time.
ESD for GTC after esophagectomy was shown to be safe and effective.
As some patients were observed for only a short time, the assessment of long-term prognosis after ESD for GTC was insufficient. Further accumulation and follow-up of cases of GTC are necessary in the future.