Experience in Simultaneous Endoscopic Submucosal Dissection Treating Synchronous Multiple Primary Early Esophageal...

Area of Science:

• Gastroenterology
• Endoscopy
• Oncology

Background:

• Synchronous multiple primary early esophageal cancers (SMPEEC) are rare but aggressive, necessitating effective treatment strategies.
• Early detection and minimally invasive treatments like endoscopic submucosal dissection (ESD) are crucial for improving survival rates in esophageal cancer.
• Clinical outcomes of simultaneous ESD for SMPEEC are not well-documented.

Purpose of the Study:

• To evaluate the clinical outcomes of simultaneous endoscopic submucosal dissection (ESD) for treating synchronous multiple primary early esophageal cancers (SMPEEC).

Main Methods:

• Retrospective review of medical data from 34 patients who underwent simultaneous ESD for SMPEEC.
• Analysis of lesion characteristics, en bloc resection rates, curative resection rates, complications, and local recurrence.
• Data collected from May 2013 to December 2014 at Zhongshan Hospital, Fudan University.

Main Results:

• Simultaneous ESD was performed on 67 lesions in 33 patients, with one patient requiring two separate operations.
• High en bloc resection rate (97.01%) and curative resection rate (92.54%) were achieved.
• Low complication rates including stricture (2 cases) and delayed bleeding (1 case), with one local recurrence and no metastasis or procedure-related deaths.

Conclusions:

• Simultaneous ESD is a technically feasible and beneficial treatment for SMPEEC, potentially reducing hospitalization time and medical expenses.
• This approach offers high en bloc and curative resection rates with acceptable safety.
• Simultaneous ESD should be avoided in patients with risk factors for complications.