Original articleClinical endoscopyOutcomes for endoscopic submucosal dissection of pathologically staged T1b esophageal cancer: a multicenter study
Section snippets
Methods
This was a retrospective cohort study of patients who underwent ESD for pathologically confirmed T1b EC at 7 academic tertiary referral centers in the United States (n = 6) and Brazil (n = 1) between January 1, 2013 and June 1, 2021. Institutional review board approval from each participating center was obtained. Information was gathered from prospectively managed databases at each institution. Study data were collected and managed using REDCap electronic data capture system hosted at the
Patient and procedure characteristics
Sixty-six patients underwent ESD for pathologically staged T1b EC. Patient demographics and lesion characteristics are presented in Table 1. The number of procedures from each center was as follows: Cleveland Clinic, 19; University of Florida, 13; University of Sao Paulo, 11; Brigham and Women’s Hospital, 7; Mayo Clinic Arizona, 8; Parkview Cancer Center, 5; and University Hospitals, 3.
Seventy-four percent of patients (49/66) had EAC and 25.8% (17/49) had ESCC. Twenty-one percent of patients
Discussion
The main finding of our study was that the R0 resection rate for ESD of T1b EC was lower (54.5%) than that reported in contemporary series of ESD for T1a EC. We found that R1 resection of T1b EC was associated with residual/recurrent disease (hazard ratio, 6.25; 95% confidence interval, 1.29-30.36; P = .023). In our series, no local or metastatic recurrence occurred after ESD resection of T1b EAC within the curative criteria. In patients with noncurative resection of T1b EC, irrespective of
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DISCLOSURE: The following authors disclosed financial relationships: P.V. Draganov: Consultant for Boston Scientific, Lumendi, Cook, Olympus, and Microtech. F. Maluf-Filho: Consultant for Boston Scientific, Cook, and Olympus America. H. Aihara: Consultant for Olympus America, Boston Scientific, Fujifilm Medical Systems, Medtronic, ConMed, and 3-D Matrix. N. Fukami, J. Vargo: Consultant for Boston Scientific and Olympus America; Advisory Board for DocBot and Aspero Medical; research funding from Olympus America, Inc. N. R. Sharma: Consultant for Boston Scientific, MedTronic, Mauna Kea Technologies, Steris, Merck, and Shark, & Dohme Corporation. A. Chak: Consultant for US Endoscopyand MicroTek Diagnostics; advisor for CDX Diagnostics; investment interest in Lucid Diagnostics. D. Yang: Consultant for Boston Scientific, Lumendi, and Steris. J. Dumot: Consultant for US Endoscopy. X. Zhang: Consultant for Merck Sharp & Dohme Corporation. S. Kamath: Consultant for Exelixis Inc and Tempus. A. Bhatt: Consultant for Boston Scientific, Lumendi, Medtronic, and Olympus; royalties from Medtronic. S. Jang: Consultant for Boston Scientific and Steris. S. Jawaid: Consultant for ConMed and Lumendi. S. Murthy: Consultant/board member for Advanced Medical Solutions, LLC All other authors disclosed no financial relationships.
See CME section, p. 563.
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