Skip to main content

Advertisement

SpringerLink
Log in

Endoscopic findings suggestive of a high risk of non-radical cure after definitive chemoradiotherapy for cT1bN0M0 esophageal squamous cell carcinoma

  • Original Article
  • Published:
Esophagus Aims and scope Submit manuscript

Abstract

Background

Definitive chemoradiotherapy (DCRT) is a curative treatment option for cT1bN0M0 esophageal squamous cell carcinoma (ESCC); however, local residual disease and recurrence after complete remission may occur. We aimed to identify endoscopic findings associated with the risk of non-radical cure (local remnant or recurrence) after DCRT for cT1bN0M0 ESCC.

Methods

We retrospectively analyzed 40 consecutive patients with cT1bN0M0 ESCC who had undergone DCRT between January 2007 and December 2017. We examined the endoscopic findings in patients with residual or recurrent (RR) disease (RR group) and those without RR disease [non-RR (NRR) group] after DCRT. We also evaluated outcomes after DCRT for each endoscopic finding.

Results

There were 10 patients in the RR group and 30 patients in the NRR group. The RR group had a significantly larger tumor size and a higher proportion of lesions with type 0–I. The 5-year relapse-free survival rate was significantly lower in type 0–I and in the presence of B3 vessels. Endoscopic findings in 15 patients with cT1bN0M0 ESCC, type 0–I, who underwent DCRT revealed significantly more reddish lesions in the RR group compared to the NRR group.

Conclusions

cT1bN0M0 ESCC large size, with B3 vessels, and type 0–I has a high risk of non-radical cure after DCRT, especially the reddish type 0–I, which may need to be considered for treatment similar to advanced cancer, including surgery with preoperative DCRT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig.1

Similar content being viewed by others

Data availability

The datasets generated during and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request.

References

  1. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.

    Article  PubMed  Google Scholar 

  2. Pennathur A, Gibson MK, Jobe BA, et al. Oesophageal carcinoma. Lancet. 2013;381:400–12.

    Article  PubMed  Google Scholar 

  3. Ishihara R, Tanaka H, Iishi H, et al. Long-term outcome of esophageal mucosal squamous cell carcinoma without lymphovascular involvement after endoscopic resection. Cancer. 2008;112:2166–72.

    Article  PubMed  Google Scholar 

  4. Mizumoto T, Hiyama T, Oka S, et al. Diagnosis of superficial esophageal squamous cell carcinoma invasion depth before endoscopic submucosal dissection. Dis Esophagus. 2018;31:dox142.

  5. Mizumoto T, Hiyama T, Quach DT, et al. Magnifying endoscopy with narrow band imaging in estimating the invasion depth of superficial esophageal squamous cell carcinomas. Digestion. 2018;98:249–56.

    Article  PubMed  Google Scholar 

  6. Tachimori Y, Ozawa S, Numasaki H, et al. Comprehensive registry of esophageal Cancer in Japan, 2011. Esophagus. 2018;15:127–52.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kitagawa Y, Uno T, Oyama T, et al. Esophageal cancer practice guidelines 2017 edited by the Japan Esophageal Society: part 1. Esophagus. 2019;16:1–24.

    Article  PubMed  Google Scholar 

  8. Kodama M, Kakegawa T. Treatment of superficial cancer of the esophagus: a summary of responses to a questionnaire on superficial cancer of the esophagus in Japan. Surgery. 1998;123:432–9.

    Article  CAS  PubMed  Google Scholar 

  9. Shimada H, Nabeya Y, Matsubara H, et al. Prediction of lymph node status in patients with superficial esophageal carcinoma: analysis of 160 surgically resected cancers. Am J Surg. 2006;191:250–4.

    Article  PubMed  Google Scholar 

  10. Allareddy V, Ward MM, Allareddy V, et al. Effect of meeting Leapfrog volume thresholds on complication rates following complex surgical procedures. Ann Surg. 2010;251:377–83.

    Article  PubMed  Google Scholar 

  11. Takeuchi H, Miyata H, Gotoh M, et al. A risk model for esophagectomy using data of 5354 patients included in a Japanese nationwide web-based database. Ann Surg. 2014;260:259–66.

    Article  PubMed  Google Scholar 

  12. Hironaka S, Ohtsu A, Boku N, et al. Nonrandomized comparison between definitive chemoradiotherapy and radical surgery in patients with T(2–3)N(any)M(0) squamous cell carcinoma of the esophagus. Int J Radiat Oncol Biol Phys. 2003;57:425–33.

    Article  PubMed  Google Scholar 

  13. Ariga H, Nemoto K, Miyazaki S, et al. Prospective comparison of surgery alone and chemoradiotherapy with selective surgery in resectable squamous cell carcinoma of the esophagus. Int J Radiat Oncol Biol Phys. 2009;75:348–56.

    Article  PubMed  Google Scholar 

  14. Ohtsu A, Boku N, Muro K, et al. Definitive chemoradiotherapy for T4 and/or M1 lymph node squamous cell carcinoma of the esophagus. J Clin Oncol. 1999;17:2915–21.

    Article  CAS  PubMed  Google Scholar 

  15. Kato H, Sato A, Fukuda H, et al. A phase II trial of chemoradiotherapy for stage I esophageal squamous cell carcinoma: Japan Clinical Oncology Group Study (JCOG9708). Jpn J Clin Oncol. 2009;39:638–43.

    Article  PubMed  Google Scholar 

  16. Kato K, Ito Y, Nozaki I, et al. Parallel-group controlled trial of surgery versus chemoradiotherapy in patients With Stage I esophageal squamous cell carcinoma. Gastroenterology. 2021;161:1878-86.e2.

    Article  CAS  PubMed  Google Scholar 

  17. Motoori M, Yano M, Ishihara R, et al. Comparison between radical esophagectomy and definitive chemoradiotherapy in patients with clinical T1bN0M0 esophageal cancer. Ann Surg Oncol. 2012;19:2135–41.

    Article  PubMed  Google Scholar 

  18. Japan Esophageal Society. Japanese Classification of Esophageal Cancer, 11th edn 2017; 14. Esophagus: 1–36.

  19. Oyama T, Momma K. A new classification of magnified endoscopy for superficial esophageal squamous cell carcinoma. Esophagus. 2011;8:247–51.

    Google Scholar 

  20. Yoshida T, Inoue H, Usui S, et al. Narrow-band imaging system with magnifying endoscopy for superficial esophageal lesions. Gastrointest Endosc. 2004;59:288–95.

    Article  PubMed  Google Scholar 

  21. Chino O, Makuuchi H, Shimada H, et al. Analysis of macroscopic tumor type by endoscopic examination as well as the invasive depth of protruding esophageal squamous cell carcinoma. Stomach Intestine (Tokyo). 2013;48:321–35.

    Google Scholar 

  22. Huang R-W, Chao Y-K, Wen YW, et al. Predictors of pathological complete response to neoadjuvant chemoradiotherapy for esophageal squamous cell carcinoma. World J Surg Oncol. 2014;12:170.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Miyazaki T, Myojin M, Hosokawa M, et al. Endoscopic resection as an independent predictive factor of local control in patients with T1bN0M0 esophageal squamous cell carcinoma treated with chemoradiotherapy: a retrospective study. Radiat Oncol. 2022;17:11.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Kadota T, Yano T, Fujita T, et al. Submucosal invasive depth predicts lymph node metastasis and poor prognosis in submucosal invasive esophageal squamous cell carcinoma. Am J Clin Pathol. 2017;148:416–26.

    Article  CAS  PubMed  Google Scholar 

  25. Duan X-F, Tang P, Shang XB, et al. The prevalence of lymph node metastasis for pathological T1 esophageal cancer: a retrospective study of 143 cases. Surg Oncol. 2018;27:1–6.

    Article  PubMed  Google Scholar 

  26. Merkow RP, Bilimoria KY, Keswani RN, et al. Treatment trends, risk of lymph node metastasis, and outcomes for localized esophageal cancer. J Natl Cancer Inst. 2014;106:1.

  27. Lee L, Ronellenfitsch U, Hofstetter WL, et al. Predicting lymph node metastases in early esophageal adenocarcinoma using a simple scoring system. J Am Coll Surg. 2013;217:191–9.

    Article  PubMed  Google Scholar 

  28. Kadota T, Minashi K, Wakabayashi M, et al. Diagnostic yield of conventional endoscopy with endoscopic ultrasonography for submucosal invasion of superficial esophageal squamous cell carcinoma: a post hoc analysis of multicenter prospective confirmatory study (JCOG0508). Esophagus. 2021;18:604–11.

    Article  PubMed  Google Scholar 

  29. Emi M, Hihara J, Hamai Y, et al. Clinicopathologic features of submucosal esophageal squamous cell carcinoma. Ann Thorac Surg. 2017;104:1858–64.

    Article  PubMed  Google Scholar 

  30. Ishihara R, Yamamoto S, Iishi H, et al. Factors predictive of tumor recurrence and survival after initial complete response of esophageal squamous cell carcinoma to definitive chemoradiotherapy. Int J Radiat Oncol Biol Phys. 2010;76:123–9.

    Article  PubMed  Google Scholar 

Download references

Funding

The authors declare no financial support associated with this manuscript.

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Hiroshima University Hospital, Hiroshima, Japan

    Motomitsu Fukuhara, Shiro Oka, Kazuki Ishibashi, Hirona Konishi & Junichi Mizuno

  2. Gastrointestinal Endoscopy and Medicine, Hiroshima University Hospital, 1-2-3, Kasumi, Minamiku, Hiroshima, 734-8551, Japan

    Yuji Urabe

  3. Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan

    Hidenori Tanaka, Akiyoshi Tsuboi, Ken Yamashita, Hidehiko Takigawa, Takahiro Kotachi, Ryo Yuge, Ryohei Hayashi & Shinji Tanaka

  4. Department of Clinical Research Center, Hiroshima University Hospital, Hiroshima, Japan

    Yuichi Hiyama

  5. Department of Radiation Oncology, Hiroshima University Hospital, Hiroshima, Japan

    Ikuno Nishibuchi, Yuji Murakami & Yasushi Nagata

Authors
  1. Motomitsu Fukuhara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuji Urabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shiro Oka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kazuki Ishibashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hirona Konishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Junichi Mizuno
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hidenori Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Akiyoshi Tsuboi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ken Yamashita
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yuichi Hiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Hidehiko Takigawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Takahiro Kotachi
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Ryo Yuge
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Ryohei Hayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Ikuno Nishibuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Yuji Murakami
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Yasushi Nagata
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Shinji Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization and methodology: YU, SO, and ST; Formal analysis and investigation: KI, HK, JM, HT, AT, KY, YH, HT, TK, RY, RH, IN, YM, and YN; Writing—original draft preparation: MF and YU; Writing—review and editing: YU, SO, and ST; Supervision: SO and ST.

Corresponding author

Correspondence to Yuji Urabe.

Ethics declarations

Ethical Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or substitute for it was obtained from all patients for being included in the study.

Conflict of interest

Motomitsu Fukuhara, Yuji Urabe, Shiro Oka, Kazuki Ishibashi, Hirona Konishi, Jyunichi Mizuno, Hidenori Tanaka, Akiyoshi Tsuboi, Ken Yamashita, Yuichi Hiyama, Hidehiko Takigawa, Takahiro Kotachi, Ryo Yuge, Ryohei Hayashi, Ikuno Nishibuchi, Yuji Murakami, Yasushi Nagata, and Shinji Tanaka declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fukuhara, M., Urabe, Y., Oka, S. et al. Endoscopic findings suggestive of a high risk of non-radical cure after definitive chemoradiotherapy for cT1bN0M0 esophageal squamous cell carcinoma. Esophagus 20, 541–547 (2023). https://doi.org/10.1007/s10388-023-00999-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10388-023-00999-w

Keywords

Search

Navigation