Management of clinical T1N0M0 esophageal cancer

Andrew J. Yang, Seo Hee Choi, Hwa Kyung Byun, Hyun Ju Kim, Jinhyun Choi, Yong Chan Lee, Sang Kil Lee, Kyung Ran Park, Chang Geol Lee

Research output: Contribution to journalArticle

Abstract

Background/Aims: Endoscopic resection is a standard treatment for stage T1a esophageal cancer, with esophagectomy or radical radiation therapy (RT) performed for stage T1b lesions. This study aimed to compare treatment outcomes of each modality for clinical stage T1 esophageal cancer. Methods: In total, 179 patients with clinical T1N0M0- stage esophageal cancer treated from 2006 to 2016 were retrospectively evaluated. Sixty-two patients with clinical T1astage cancer underwent endoscopic resection. Among 117 patients with clinical T1b-stage cancer, 82 underwent esophagectomy, and 35 received chemoradiotherapy or RT. We compared overall survival (OS) and recurrence-free survival (RFS) rates for each treatment modality. Results: The median follow-up time was 32 months (range, 1 to 120 months). The 5-year OS and RFS rates for patients with stage T1a cancer receiving endoscopic resection were 100% and 85%, respectively. For patients with stage T1b, the 5-year OS and RFS rates were 78% and 77%, respectively, for the esophagectomy group; 80% and 44%, respectively, for the RT alone group; and 96% and 80%, respectively, for the chemoradiation group. The esophagectomy group showed significantly higher RFS than the RT alone group (p=0.04). There was no significant difference in RFS between the esophagectomy and chemoradiation groups (p=0.922). Grade 4 or higher treatment-related complications occurred in four patients who underwent esophagectomy. Conclusions: ndoscopic resection appeared to be an adequate treatment for patients with T1a-stage esophageal cancer. The multidisciplinary approach involving chemoradiation was comparable to esophagectomy in terms of survival outcome without serious complications for T1b-stage esophageal cancer.

Original languageEnglish
Pages (from-to)315-324
Number of pages10
JournalGut and liver
Volume13
Issue number3
DOIs
Publication statusPublished - 2019 Jan 1

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Esophagectomy
Esophageal Neoplasms
Survival
Recurrence
Radiotherapy
Survival Rate
Neoplasms
Chemoradiotherapy
Therapeutics

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Yang, A. J., Choi, S. H., Byun, H. K., Kim, H. J., Choi, J., Lee, Y. C., ... Lee, C. G. (2019). Management of clinical T1N0M0 esophageal cancer. Gut and liver, 13(3), 315-324. https://doi.org/10.5009/gnl18254
Yang, Andrew J. ; Choi, Seo Hee ; Byun, Hwa Kyung ; Kim, Hyun Ju ; Choi, Jinhyun ; Lee, Yong Chan ; Lee, Sang Kil ; Park, Kyung Ran ; Lee, Chang Geol. / Management of clinical T1N0M0 esophageal cancer. In: Gut and liver. 2019 ; Vol. 13, No. 3. pp. 315-324.
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abstract = "Background/Aims: Endoscopic resection is a standard treatment for stage T1a esophageal cancer, with esophagectomy or radical radiation therapy (RT) performed for stage T1b lesions. This study aimed to compare treatment outcomes of each modality for clinical stage T1 esophageal cancer. Methods: In total, 179 patients with clinical T1N0M0- stage esophageal cancer treated from 2006 to 2016 were retrospectively evaluated. Sixty-two patients with clinical T1astage cancer underwent endoscopic resection. Among 117 patients with clinical T1b-stage cancer, 82 underwent esophagectomy, and 35 received chemoradiotherapy or RT. We compared overall survival (OS) and recurrence-free survival (RFS) rates for each treatment modality. Results: The median follow-up time was 32 months (range, 1 to 120 months). The 5-year OS and RFS rates for patients with stage T1a cancer receiving endoscopic resection were 100{\%} and 85{\%}, respectively. For patients with stage T1b, the 5-year OS and RFS rates were 78{\%} and 77{\%}, respectively, for the esophagectomy group; 80{\%} and 44{\%}, respectively, for the RT alone group; and 96{\%} and 80{\%}, respectively, for the chemoradiation group. The esophagectomy group showed significantly higher RFS than the RT alone group (p=0.04). There was no significant difference in RFS between the esophagectomy and chemoradiation groups (p=0.922). Grade 4 or higher treatment-related complications occurred in four patients who underwent esophagectomy. Conclusions: ndoscopic resection appeared to be an adequate treatment for patients with T1a-stage esophageal cancer. The multidisciplinary approach involving chemoradiation was comparable to esophagectomy in terms of survival outcome without serious complications for T1b-stage esophageal cancer.",
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Yang, AJ, Choi, SH, Byun, HK, Kim, HJ, Choi, J, Lee, YC, Lee, SK, Park, KR & Lee, CG 2019, 'Management of clinical T1N0M0 esophageal cancer', Gut and liver, vol. 13, no. 3, pp. 315-324. https://doi.org/10.5009/gnl18254

Management of clinical T1N0M0 esophageal cancer. / Yang, Andrew J.; Choi, Seo Hee; Byun, Hwa Kyung; Kim, Hyun Ju; Choi, Jinhyun; Lee, Yong Chan; Lee, Sang Kil; Park, Kyung Ran; Lee, Chang Geol.

In: Gut and liver, Vol. 13, No. 3, 01.01.2019, p. 315-324.

Research output: Contribution to journalArticle

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AU - Byun, Hwa Kyung

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AU - Choi, Jinhyun

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AU - Lee, Sang Kil

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AU - Lee, Chang Geol

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N2 - Background/Aims: Endoscopic resection is a standard treatment for stage T1a esophageal cancer, with esophagectomy or radical radiation therapy (RT) performed for stage T1b lesions. This study aimed to compare treatment outcomes of each modality for clinical stage T1 esophageal cancer. Methods: In total, 179 patients with clinical T1N0M0- stage esophageal cancer treated from 2006 to 2016 were retrospectively evaluated. Sixty-two patients with clinical T1astage cancer underwent endoscopic resection. Among 117 patients with clinical T1b-stage cancer, 82 underwent esophagectomy, and 35 received chemoradiotherapy or RT. We compared overall survival (OS) and recurrence-free survival (RFS) rates for each treatment modality. Results: The median follow-up time was 32 months (range, 1 to 120 months). The 5-year OS and RFS rates for patients with stage T1a cancer receiving endoscopic resection were 100% and 85%, respectively. For patients with stage T1b, the 5-year OS and RFS rates were 78% and 77%, respectively, for the esophagectomy group; 80% and 44%, respectively, for the RT alone group; and 96% and 80%, respectively, for the chemoradiation group. The esophagectomy group showed significantly higher RFS than the RT alone group (p=0.04). There was no significant difference in RFS between the esophagectomy and chemoradiation groups (p=0.922). Grade 4 or higher treatment-related complications occurred in four patients who underwent esophagectomy. Conclusions: ndoscopic resection appeared to be an adequate treatment for patients with T1a-stage esophageal cancer. The multidisciplinary approach involving chemoradiation was comparable to esophagectomy in terms of survival outcome without serious complications for T1b-stage esophageal cancer.

AB - Background/Aims: Endoscopic resection is a standard treatment for stage T1a esophageal cancer, with esophagectomy or radical radiation therapy (RT) performed for stage T1b lesions. This study aimed to compare treatment outcomes of each modality for clinical stage T1 esophageal cancer. Methods: In total, 179 patients with clinical T1N0M0- stage esophageal cancer treated from 2006 to 2016 were retrospectively evaluated. Sixty-two patients with clinical T1astage cancer underwent endoscopic resection. Among 117 patients with clinical T1b-stage cancer, 82 underwent esophagectomy, and 35 received chemoradiotherapy or RT. We compared overall survival (OS) and recurrence-free survival (RFS) rates for each treatment modality. Results: The median follow-up time was 32 months (range, 1 to 120 months). The 5-year OS and RFS rates for patients with stage T1a cancer receiving endoscopic resection were 100% and 85%, respectively. For patients with stage T1b, the 5-year OS and RFS rates were 78% and 77%, respectively, for the esophagectomy group; 80% and 44%, respectively, for the RT alone group; and 96% and 80%, respectively, for the chemoradiation group. The esophagectomy group showed significantly higher RFS than the RT alone group (p=0.04). There was no significant difference in RFS between the esophagectomy and chemoradiation groups (p=0.922). Grade 4 or higher treatment-related complications occurred in four patients who underwent esophagectomy. Conclusions: ndoscopic resection appeared to be an adequate treatment for patients with T1a-stage esophageal cancer. The multidisciplinary approach involving chemoradiation was comparable to esophagectomy in terms of survival outcome without serious complications for T1b-stage esophageal cancer.

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Yang AJ, Choi SH, Byun HK, Kim HJ, Choi J, Lee YC et al. Management of clinical T1N0M0 esophageal cancer. Gut and liver. 2019 Jan 1;13(3):315-324. https://doi.org/10.5009/gnl18254