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Comparison of Long Term Survival After Endoscopic Resection vs. Ablation in Early Esophageal Cancer: an Analysis of Surveillance Epidemiology and End Results Data
Attila Dubecz*1, Norbert Solymosi2, Rudolf J. Stadlhuber1, Michael Schweigert1, Jeffrey H. Peters3, Hubert J. Stein1
1Surgery, Klinikum Nurnberg, Nurnberg, Germany; 2Faculty of Veterinary Science, Szent Istvan University, Budapest, Hungary; 3Division of Thoracic and Foregut Surgery, Department of Surgery, University of Rochester School of Medicine and Dentistry, Rochester, NY
BACKGROUND:
Safety and efficacy of endoscopic therapy for early esophageal cancer is well established but long-term outcomes are not available. Our objective was to assess and compare long-term survival in patients with early esophageal cancer managed with either endoscopic mucosal resection (EMR) or ablative treatments (AT).
METHODS:
We identified 495 patients with endoscopically treated early adenocarcinoma of the esophagus and the gastric cardia diagnosed between 1998 and 2009 from the Surveillance, Epidemiology, and End Results (SEER) database. Demographic variables and cancer-related survival were assessed.
RESULTS:
Almost 80% of all patients were male. Average age was 66.5y. Forty-percent of the patients had T1a cancer. More than 88% of the patients were treated with EMR. Average follow-up was 33.6 months. Although five-year cancer related survival was slightly superior after AT (81% vs.78%; p<0.001), ten-year survival rates were significantly better in patients undergoing EMR (78% vs. 61%; p<0.001).
CONCLUSION:
Patients with early esophageal cancer managed with EMR have superior long-term
survival compared to those treated with ablative therapies.
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