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Risk of lymph node metastases in patients with T1b oesophageal adenocarcinoma: A retrospective single centre experience 被引量:1
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作者 David Graham Nejc Sever +11 位作者 Cormac Magee William Waddingham Matthew Banks Rami Sweis Hannah Al-Yousuf Miriam Mitchison Durayd Alzoubaidi Manuel Rodriguez-Justo Laurence Lovat Marco Novelli Marnix Jansen Rehan Haidry 《World Journal of Gastroenterology》 SCIE CAS 2018年第41期4698-4707,共10页
AIM To assess clinical outcomes for submucosal (T1b) oesophageal adenocarcinoma (OAC) patients managed with either surgery or endoscopic eradication therapy.METHODS Patients found to have T1b OAC following endoscopic ... AIM To assess clinical outcomes for submucosal (T1b) oesophageal adenocarcinoma (OAC) patients managed with either surgery or endoscopic eradication therapy.METHODS Patients found to have T1b OAC following endoscopic resection between January 2008 to February 2016 at University College London Hospital were retrospectively analysed. Patients were split into low-risk and high-risk groups according to established histopathological criteria and were then further categorised according to whether they underwent surgical resection or conservative management. Study outcomes include the presence of lymphnode metastases, disease-specific mortality and overall survival. RESULTS A total of 60 patients were included; 22 patients were surgically managed (1 low-risk and 21 high-risk patients) whilst 38 patients were treated conservatively (12 low-risk and 26 high-risk). Overall, lymph node metastases (LNM) were detected in 10 patients (17%); six of these patients had undergone conservative management and LNM were detected at a median of 4 mo after endoscopic mucosal resection (EMR). All LNM occurred in patients with highrisk lesions and this represented 21% of the total high-risk lesions. Importantly, there was no statistically significant difference in tumor-related deaths between those treated surgically or conservatively (P = 0.636) and disease-specific survival time was also comparable between the two treatment strategies (P = 0.376).CONCLUSION T1b tumours without histopathological high-risk markers of LNM can be treated endoscopically with good outcomes. In selected patients, endoscopic therapy may be appropriate for high-risk lesions. 展开更多
关键词 OESOPHAGEAL ADENOCARCINOMA SUBMUCOSAL invasion T1b LYMPH node metastasis RISK prediction Endoscopy
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