LONG-TERM OUTCOME FOR PATIENTS WITH ESOPHAGEAL SQUAMOUS CELL CARCINOMA WHO UNDERWENT ARGON PLASMA COAGULATION

Background:

EMR or ESD is regarded to be the best treatment for patients with early-stage gastrointestinal cancer. However, APC is often selected as treatment for such patients because of the patient's general condition or status of the lesions, and the usefulness of APC has been reported. However, there have been very few reports about the long-term outcome for patients who underwent APC.

Methods:

We studied outcomes for 24 patients with esophageal squamous cell carcinoma (27 lesions) who underwent APC between October 2004 and September 2014. All of the patients did not undergo EMR/ESD because the lesions had submucosal fibrosis (near the scar of the previous EMR/ESD, local recurrence or metachronous cancer after radiotherapy, on the anastomosis) and were therefore judged to have a high risk of perforation. Mean lesion size was 1.4 cm (0.5 – 4.0 cm). APC was performed after submucosal injection of saline.

Results:

Follow-up periods were 11 to 122 months (median period of 48.5 months). There was no adverse event such as perforation, bleeding or esophageal stenosis. Local recurrence was found in 1 patient (1 lesion) (3.6%). No metastasis was found. The current study revealed that the 5-year overall survival rate was 69.6% and that the 5-year cause-specific survival rate was 100%.

Discussion:

Previous studies on ESD for esophageal cancer showed that local recurrence rates were 0 – 3.1% and that the 5-year cause specific survival rates were 95 – 100%. The results of the current study were the same as those results. We consider that submucosal injection prior to APC would result in uniform and sufficient coagulation and would contribute to a good outcome.

Conclusion:

APC is useful for patients with early esophageal cancer who have a risk of perforation during ESD because of submucosal fibrosis.