Background and Aims
Endoscopic multiband mucosectomy (EMBM) has been used to treat early Barrett’s esophagus
and esophagogastric junction neoplasia, yet it is seldom reported for the treatment
of early esophageal squamous cell neoplasia. Here we retrospectively evaluated the
feasibility, safety, and efficacy of EMBM for early esophageal squamous cell neoplasia.
Methods
A total of 125 patients were included in the study. Lesions were delineated using
electrocoagulation and resected using the EMBM technique. The primary outcomes were
local recurrence and adverse events. Secondary outcomes were histology of the endoscopic
resection specimens, specimen area, and speed of resection. All patients were followed
up endoscopically.
Results
There were 135 esophageal lesions, of which 40 were pathologically diagnosed as low-grade
intraepithelial neoplasia, 57 as high-grade intraepithelial neoplasia, 34 as early
esophageal cancer, and 4 as squamous epithelium without neoplasia. No severe adverse
events were observed, except for 1 perforation, which was treated by application of
clips. The median follow-up was 27.75 months. Three patients had local recurrence
and were endoscopically treated again. Local recurrence rate was 2.4% (3/125). No
deaths occurred during the follow-up. All specimens were visible with a dividing rule,
and the mean specimen area was 4.63 cm2. Mean operation time was 31.2 ± 17.4 minutes. Mean speed of resection was 6.74 min/cm2.
Conclusions
EMBM seems to be effective and safe for patients with early esophageal squamous cell
neoplasia. The long-term recurrence rate is low.
Abbreviations:
APC (argon plasma coagulation), EMBM (endoscopic multiband mucosectomy), ESCC (esophageal squamous cell cancer), ESCN (esophageal squamous cell neoplasia), ESD (endoscopic submucosal dissection), HGIN (high-grade intraepithelial neoplasia), IQR (interquartile range), LGIN (low-grade intraepithelial neoplasia)To read this article in full you will need to make a payment
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References
- The incidence and mortality of esophageal cancer and their relationship to development in Asia.Ann Transl Med. 2016; 4: 29-40
- Recent changes in the epidemiology of esophageal cancer.Surg Oncol. 2001; 10: 81-90
- Oesophageal carcinoma.Lancet. 2013; 381: 400-412
- GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet].International Agency for Research on Cancer, Lyon, France2013 (Available at:) (Accessed December 12, 2013)
- Cancer incidence and mortality data in Aktobe, west Kazakhstan, 2000-2010.Asian Pac J Cancer Prev. 2015; 16: 2379-2383
- Epidemiology of esophageal cancer.World J Gastroenterol. 2013; 19: 5598-5606
- Epidemiologic risk factors for esophageal cancer development.Asian Pac J Cancer Prev. 2011; 12: 2461-2466
- The incidence of oesophageal cancer in Eastern Africa: identification of a new geographic hot spot?.Cancer Epidemiol. 2015; 39: 143-149
- Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012.Int J Cancer. 2015; 136: E359-E386
- Demographic survey of four thousand patients with 10 common cancers in North Eastern Iran over the past three decades.Asian Pac J Cancer Prev. 2014; 15: 10193-10198
- Endoscopic approaches for early-stage esophageal cancer: current options.Curr Oncol Rep. 2015; 17: 421-427
- Endoscopic mucosal resection and endoscopic submucosal dissection. Technology status evaluation report.Gastrointest Endosc. 2008; 68: 11-18
- Endoscopic treatment of high-grade dysplasia and early stage cancer in Barrett’s esophagus.Gastrointest Endosc. 2005; 61: 506-514
- Expansion of the indications for endoscopic mucosal resection in patients with superficial esophageal carcinoma.Endoscopy. 2007; 39: 36-40
- Endoscopic submucosal dissection for early esophageal neoplasia: a single center experience in South Taiwan.J Formos Med Assoc. 2012; 111: 132-139
- Endoscopic submucosal tunnel dissection for large esophageal neoplastic lesions.Endoscopy. 2013; 45: 1032-1034
- Esophageal morphology from Linxian, China. Squamous histologic findings in 754 patients.Cancer. 1994; 73: 2027-2037
- Squamous esophageal histology and subsequent risk of squamous cell carcinoma of the esophagus. A prospective follow-up study from Linxian, China.Cancer. 1994; 74: 1686-1692
- Histological precursors of oesophageal squamous cell carcinoma: results from a 13 year prospective follow up study in a high risk population.Gut. 2005; 54: 187-192
- Short term results of endoscopic submucosal dissection in superficial esophageal squamous cell neoplasms.World J Gastrointest Endosc. 2010; 2: 69-74
- Endoscopic submucosal dissection in patients with early esophageal squamous cell carcinoma: results from a prospective Western series.Gastrointest Endosc. 2010; 71: 715-721
- Multiband mucosectomy for endoscopic resection of Barrett's esophagus: feasibility study with matched historical controls.Eur J Gastroenterol Hepatol. 2007; 19: 311-315
- EMR is not inferior to ESD for early Barrett’s and EGJ neoplasia: an extensive review on outcome, recurrence and complication rates.Endosc Int Open. 2014; 2: E58-E64
- Endoscopic mucosal resection of early cancer and high-grade dysplasia in Barrett's esophagus.Gastroenterology. 2000; 118: 670-677
- Local endoscopic therapy for intraepithelial high-grade neoplasia and early adenocarcinoma in Barrett's oesophagus: acute-phase and intermediate results of a new treatment approach.Eur J Gastroenterol Hepatol. 2002; 14: 1085-1091
- Clinical outcomes of endoscopic submucosal dissection for superficial esophageal neoplasms: a multicenter retrospective cohort study.Endoscopy. 2015; 47: 775-783
- Endoscopic and oncologic outcomes of endoscopic resection for superficial esophageal neoplasm.Gut Liver. 2015; 9: 470-477
- Comparison of EMR and endoscopic submucosal dissection for en bloc resection of early esophageal cancers in Japan.Gastrointest Endosc. 2008; 68: 1066-1072
- Risk factors for local recurrence of superficial esophageal cancer after treatment by endoscopic mucosal resection.Endoscopy. 2007; 39: 41-45
- Efficacy and safety of endoscopic submucosal dissection for superficial squamous esophageal neoplasia: a meta-analysis.Dig Dis Sci. 2014; 59: 1862-1869
- Metachronous squamous cell carcinoma of the esophagus arising after endoscopic mucosal resection.Gastrointest Endosc. 2001; 54: 190-194
- Metachronous multiple esophageal squamous cell carcinomas and Lugol-voiding lesions after endoscopic mucosal resection.Endoscopy. 2009; 41: 304-309
- Association of multiple Lugol-voiding lesions with synchronous and metachronous esophageal squamous cell carcinoma in patients with head and neck cancer.Gastrointest Endosc. 2002; 56: 517-521
Article info
Publication history
Published online: April 20, 2016
Accepted:
April 7,
2016
Received:
December 29,
2015
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
Identification
Copyright
Copyright © 2016 by the American Society for Gastrointestinal Endoscopy
