- Endoscopic mucosal resection (EMR) was safe in patients with endoscopic ultrasound-staged cT2N0 esophageal cancer and eliminated all signs of disease in some, with no added complications.
Why this matters
- Patients with cT2N0 esophageal cancer diagnosed by endoscopic ultrasound often undergo surgery only to be found to have superficial disease. EMR could spare some from surgical morbidity and mortality.
- Single-center, retrospective analysis of 75 patients with cT2N0 with predicted low risk of lymph node metastasis. 30 underwent an EMR attempt, 45 underwent trimodality therapy or esophagectomy alone.
- Funding: Mason Family, anonymous donors, and departmental support.
- Patients who underwent EMR were older (71 vs 63 years; P<.001 had fewer gastroesophageal junction tumors vs smaller cm p and were less fludeoxyglucose>
- There were no perforations or immediate complications in the EMR group.
- 17/30 had complete clearance of disease following EMR. In 4 of these 17 patients, there was lymphovascular invasion. There were no recurrences or cancer-related deaths in this group.
- No variables were found to predict whether or not EMR would clear all known disease.
- Retrospective design.
- Single institution.
- Small sample size.