Introduction: After noncurative endoscopic submucosal dissection (ESD) of superficial esophageal squamous cell carcinoma (SESCC), additional esophagectomy is generally recommended. However, considering its high mortality and morbidity, it is uncertain if additional surgery improves the clinical outcomes. This study aimed to compare the clinical outcomes between patients who were observed without additional treatment and those who underwent radical esophagectomy. Methods: A total of 52 patients with SESCC who underwent complete but noncurative ESD from January 2008 to December 2016 at the Samsung Medical Center and Asan Medical Center in Korea were retrospectively analyzed. Clinicopathologic characteristics and oncologic outcomes were compared between the observation group (n = 23) and the additional surgery group (n = 29). Results: During a mean follow-up of 34.4 and 41.7 months, respectively, the rates of death (observation vs. surgery, 17.4 vs. 10.3%; p = 0.686), recurrence (observation vs. surgery, 13 vs. 17.2%; p = 1.000), and disease-specific death (observation vs. surgery, 4.3 vs. 6.9%; p = 1.000) did not significantly differ between the 2 groups. The 3-year overall survival was 86.3 and 96.4%, respectively (p = 0.776). The 3-year recurrence-free survival (observation vs. surgery, 85.0 vs. 88.7%; p = 0.960) and disease-specific survival (observation vs. surgery, 95.2 vs. 96.4%; p = 0.564) also did not significantly differ. Conclusions: The clinical outcomes of close observation of noncuratively resected SESCC are comparable to those of additional surgery, at least in the midterm. The wait-and-see strategy could be a feasible management option after noncurative ESD of SESCC in selected patients.
Dig Surg

中文翻译：

---

食管鳞状细胞癌非治愈性内镜切除术后密切观察与额外手术的比较

简介：在对浅表食管鳞状细胞癌 (SESCC) 进行非治愈性内镜黏膜下剥离术 (ESD) 后，通常建议进行额外的食管切除术。然而，考虑到其高死亡率和发病率，尚不确定额外手术是否能改善临床结果。本研究旨在比较未经额外治疗观察到的患者与接受根治性食管切除术的患者之间的临床结果。方法：回顾性分析了 2008 年 1 月至 2016 年 12 月在韩国三星医疗中心和牙山医疗中心接受完全但非治愈性 ESD 的 52 例 SESCC 患者。比较观察组的临床病理特征和肿瘤学结局（ n= 23) 和附加手术组 ( n = 29)。结果：分别在 34.4 和 41.7 个月的平均随访期间，死亡率（观察 vs. 手术，17.4 vs. 10.3%；p = 0.686）、复发率（观察 vs. 手术，13 vs. 17.2%；p = 1.000），并且疾病特异性死亡（观察与手术，4.3 与 6.9%；p = 1.000）在两组之间没有显着差异。3 年总生存率分别为 86.3% 和 96.4%（p = 0.776）。3 年无复发生存率（观察 vs. 手术，85.0 vs. 88.7%；p = 0.960）和疾病特异性生存率（观察 vs. 手术，95.2 vs. 96.4%；p= 0.564) 也没有显着差异。结论：密切观察非治愈性切除的 SESCC 的临床结果与额外手术的临床结果相当，至少在中期是这样。在选定的患者中，SESCC 的非治愈性 ESD 后，观望策略可能是一种可行的管理选择。
挖掘外科