Preliminary study on efficacy of radiofrequency ablation combined with endoscopic resection for ;eradicating widespread early non-flat type esophageal squamous cell carcinoma
10.3760/cma.j.issn.1671-0274.2015.09.007
- VernacularTitle:内镜下射频消融术联合内镜黏膜切除术治疗大面积非表浅平坦型早期食管鳞状细胞癌和癌前病变疗效初探
- Author:
Yueming ZHANG
1
;
Bergman JGHM JACQUES
;
Liyan XUE
;
Shun HE
;
Ning LYU
;
Fleischer E DAVID
;
Weusten BAS
;
Dawsey M SANFORD
;
Lizhou DOU
;
Guiqi WANG
Author Information
1. 100021,北京协和医学院中国医学科学院肿瘤医院内镜科
- Keywords:
Radiofrequency ablation;
Endoscopic resection;
Early non-flat esophageal squamous cell carcinoma;
Precancerous lesions
- From:
Chinese Journal of Gastrointestinal Surgery
2015;(9):875-880
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of radiofrequency ablation (RFA) combined with endoscopic resection (ER) for eradicating widespread early non-flat type esophageal squamous cell carcinoma (ESCC) and precancerous lesions. Methods Retrospective analysis was performed on the clinical data of 4 patients with early non-flat type ESCC and precancerous lesions in January 2010 at the Cancer Institute and Hospital, Chinese Academy of Medical Sciences. Proportion of patients with histological complete response (CR) 3 months, 12 months to 5 years after operation and adverse events were observed. Results These 4 patients were all male, aged from 47 to 71 (mean age 62) years, including 2 of ESCC, 1 of HGIN, 1 of MGIN confirmed by pathology. USL length was 6-12 (mean 8.5) cm. Treatment area (TA) length was 8-14 (mean 10.5) cm. Three cases were 0-Ⅱa(mean length 2 cm), and 1 case 0-Ⅱc (mean length 4 cm). Lesions of 2 cases were complete cycle, and other 2 cases occupied 3/4 circumference. Four patients completed their operations successfully. Total operation time was 42-105 (mean 66.8) min, RFA time was 3-12 (mean 8.25) min, and ER time was 6-20 (10.25) min, without bleeding and perforation. The mean hospital stay was 3 days. Pathology examination showed that 2 cases were ESCC G2(lesion length 12, 8 cm; non-flat type lesion length 3, 4 cm), 1 was HGIN (lesion length 12 cm; non-flat type lesion length 1 cm) and 1 was MGIN (lesion length 6 cm; non-flat type lesion length 2 cm). Three cases were CR 3 months, 1 to 5 years after operation. One case had HGIN at 3-month and MGIN at 1-year and 3-year during follow up , and was CR after treatment with HALO. Postoperative esophageal stenosis occurred in 4 cases. Among them , 2 cases were mild without treatment, and 2 were severe, who were relieved by endoscopic water sac dilation for 5-8 (mean 6.5) times. Conclusion RFA combined with ER is effective and safe in the treatment of patients with early non-flat esophageal squamous cell carcinoma and precancerous lesions.
