Highlights
- •Endoscopic resection for cT1N0M0 squamous cell carcinoma had comparable survival rates to esophagectomy.
- •Esophagectomy and endoscopic resection had a risk-adjusted absolute survival advantage of 27% and 21% relative to CRT.
- •Endoscopic resection was associated with accelerated rates of post-operative recovery but higher rates of R1 resection.
Abstract
Background
The efficacy of endoscopic resection in early-stage esophageal squamous cell carcinoma
has not been defined.
Methods
We queried the National Cancer Database to identify patients presenting with cT1N0M0
esophageal squamous cell cancer between 2004 and 2017. Transitive match methods were
used to 1:1:1 propensity match patients undergoing endoscopic resection to patients
undergoing esophagectomy and those undergoing definitive chemoradiotherapy. Kaplan
Meier method was used to compare 5-year overall survival profiles for matched cohorts.
Results
301 patients (19%) underwent endoscopic resection; 497 (32%) esophagectomy; 767 (49%)
chemoradiation. On comparison of matched cohorts, patients undergoing chemoradiation
demonstrated lower rates of survival than those undergoing esophagectomy (32% vs.
59%, p < 0.0001) while those undergoing endoscopic resection demonstrated rates comparable
to patients undergoing esophagectomy (53% vs. 59%, p = 0.77).
Conclusions
For cT1N0M0 esophageal squamous cell cancer, endoscopic resection is associated with
rates of survival similar to those following esophagectomy and better than those following
definitive chemoradiation.
Keywords
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References
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Article info
Publication history
Published online: December 01, 2022
Accepted:
November 30,
2022
Received in revised form:
October 25,
2022
Received:
July 8,
2022
Footnotes
☆This work will be featured in an oral presentation at the Midwest Surgical Association annual meeting, held in Mackinac Island, Michigan from August 7–9, 2022.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
