Risk Factors of Non-curative Resection in Superficial Esophageal Cancer After Endoscopic Submucosal Dissection and Long-term Survival Analysis

Abstract

Objective To identify risk factors of non-curative resection in superficial esophageal cancer (SEC) after endoscopic submucosal dissection and to evaluate the prognosis. Methods We retrospectively analyzed the data of 207 SEC patients who received ESD. The median follow-up was 48 months. Results The en bloc resection rate was 89.25% (191/214), the complete resection rate was 80.84 % (173/214), the curative resection rate was 70.09% (150/214) and the non-curative resection rate was 29.91% (64/214). The maximum long diameter of specimen was 110 mm. Age, gender, tumor size, lesions performance during surgery and operation time were associated with the non-curative resection (P < 0.05). Female, lesion diameter≥50mm and poorly performed lesions were identified as significant risk factors for non-curative resection. In the non-curative resection group, there was no difference in cancer-free survival and survival between patients who had no additional treatmeat after ESD and those who underwent surgery or radiotherapy. Conclusion For patients with poor general condition who are not willing to undergo surgery or chemoradiotherapy, regular endoscopy seems to be an option.

Keywords

• superficial esophageal cancer
• endoscopic submucosal dissection
• non-curative resection
• risk factors
• survival analysis