| Strategic International Session3（S）(JSGS・JSGE・JGES) |
| Fri. November 1st 14:00 - 17:00 Room 11: Portopia Hotel South Wing Topaz |
| Strategic staging endoscopic submucosal dissection for esophagogastric junction cancer | |||
| Seiichiro Abe1, Hiroyuki Daiko2, Takaki Yoshikawa3 | |||
| 1Endoscopy Division, National Cancer Center Hospital, 2Department of Esophageal Surgery, National Cancer Center Hospital, 3Department of Gastric Surgery, National Cancer Center Hospital | |||
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| Background: Endoscopic depth diagnosis for esophagogastric junction (EGJ) cancer including Barretts esophageal adenocarcinoma (BEA) is uncertain, especially for the diagnosis of cT1b, which may lead to overtreatment. We introduced staging ESD for inconclusive cT1a as well as cT1b EGJ cancer to determine the pathologic depth of invasion and make further treatment decision. The aim of this study is to investigate the feasibility and efficacy of staging ESD. Methods: This study included patients with EGJ cancer and BEA who underwent ESD between 2020/1 and 2024/4. Endoscopic depth diagnosis was performed based on the macroscopic appearance of the tumor and categorized as cT1a(conclusive), cT1a(inconclusive), or cT1b. EUS was performed to determine eligibility for ESD at the discretion of the endoscopists. This study evaluated en bloc, R0, and curative resection rates in staging ESD. Results: Thirty-four patients underwent ESD, and their preoperative diagnoses [cT1a(conclusive)/cT1a(inconclusive)/cT1b] were 23, 5, and 6, respectively. Additional EUS was performed in 5 patients [2 with cT1a(inconclusive) and 3 with cT1b] and suggested possible R0 resection. Staging ESD was performed in 11 patients and the en bloc, R0, and curative resection rates were 100%, 82%, and 55%, respectively. Four of six patients (66%) with cT1b showed pT1a, and achieved curative ESD resection. Conclusions: Staging ESD is a feasible treatment that allows detailed histologic depth diagnosis, which could avoid overtreatment. |
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Index Term 1: endoscopic submucosal dissection Index Term 2: esophagogastric junction cancer |
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