Outcomes of Endoscopic Therapy for Early Stage Esophageal Cancer, 2017

Introduction: Endoscopic mucosal resection (EMR) is a commonly used treatment for high grade dysplasia (HGD) and early stages of esophageal adenocarcinoma (EAC) in patients with Barrett’s esophagus (BE). This study describes the experience of one institution with EMR and discusses outcomes after endoscopic therapy. Methods: The patient database at Memorial Sloan Kettering Cancer Center (MSKCC) was searched for all patients who received endoscopic muscosal resection for Barrett’s esophagus with high grade dysplasia or esophageal adenocarcinoma. A database was created, including demographic information, risk factors, and procedural outcomes, for all of these patients. The outcomes after endoscopic treatment were described. Results: Complete response was achieved in 75% of patients who presented with high grade dysplasia or esophageal adenocarcinoma and 63% of patients who presented with Barrett’s esophagus. The recurrence rate was 8.3% for patients with high grade dysplasia or esophageal adenocarcinoma and 3.7% for patients with Barrett’s esophagus. Discussion: This study suggests that endoscopic mucosal resection is an overall effective treatment for high grade dysplasia and esophageal adenocarcinoma. Risk factors, including cigarette smoking and high BMI, may play a role in increasing the incidence of recurrence. Further investigation of these factors in a more generalized study can yield important information for the promotion of long-term success rates of patients who receive endoscopic therapy for esophageal abnormalities.