Original ArticleLocal recurrence of squamous-cell carcinoma of the esophagus after EMR
Section snippets
Patients and methods
A total of 229 consecutive patients with esophageal cancer underwent EMR between February 1993 and March 2002. Among them, 116 patients, with a total of 165 lesions, who met the following criteria were included in the present retrospective study: (1) newly diagnosed squamous-cell carcinoma of the esophagus, (2) tumor invasion histopathologically confined to the mucosal layer, (3) no prior treatment, (4) no additional treatment immediately after EMR, and (5) follow-up longer than 1 year. Written
Results
Patient characteristics are shown in Table 1. The study group included 116 patients (103 men, 13 women; mean age 64 [8.8] years). Forty-two patients (36.2%) had synchronous or metachronous multiple cancers in the head and neck region, and 24 (20.7%) had synchronous or metachronous multiple cancers in the esophagus. Mean tumor size was 20.5 (15.7) mm. The tumor location was as follows: proximal third of the esophagus, 22 lesions (13.3%); middle third, 88 (53.3%); and distal third, 55 (33.3%).
Discussion
EMR is well recognized as a standard treatment for superficial esophageal cancer. Clinically, local recurrence after EMR is an important issue with respect to curative treatment and has been reported to occur in 2.4% to 7.8% of cases.22, 23, 24 However, a significant predictor of local recurrence and the optimal curative treatment for such lesions have not been described.
The results of the present study show that multiple LVLs are an independent risk factor for local recurrence. Indeed, when
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