Endoscopic mucosal resection for squamous premalignant and early malignant lesions of the esophagus

Background and study aims: Endoscopic mucosal resection (EMR) is used to treat premalignant and malignant digestive tract lesions. This report presents the efficacy and safety of EMR for squamous superficial neoplastic esophageal lesions. Patients and methods: A retrospective cohort study presented data from 51 patients with 54 lesions over an 8-year period, between November 1997 and September 2005. Dysplasias or mucosal (m) T1 carcinomas were treated with repeated EMR until there was complete local remission. Patients with submucosal (sm) T1 carcinomas or more advanced stage were offered surgery or chemoradiotherapy. Results: There was no mortality, perforation, or major hemorrhage, and there were three easily dilated stenoses. Of the patients, 16 had lesions graded as T1sm or more advanced and one patient was found to have normal tissue post EMR. Complete local remission was achieved in 31 of the 34 patients with dysplasia or T1 m cancers (91%). There was no distant relapse and there was local disease recurrence in eight of the 31 patients (26%). The 5-year survival rate was 58%, while the disease specific 5-year survival rate was 95%. Conclusions: EMR for squamous superficial neoplastic lesions of the esophagus is safe and provides satisfactory survival results.