61 THE 5-YEAR RESULTS FOR ENDOSCOPIC TREATMENT OF SUPERFICIAL ESOPHAGEAL CANCER AT A NORWEGIAN UNIVERSITY HOSPITAL

Abstract

Abstract Superficial esophageal cancer (HGD = high grade dysplasia, T1a and T1b with no evidence of spread) accounts for about 20 % of all esophageal cancers. Traditionally, radical esophagectomy, with a significant degree of comorbidity has been the mainstay of treatment. Now most international guidelines, including the ESGE (European Society of Gastrointestinal Endoscopy) recommends endoscopic treatment as the first choice of treatment. The aim of this abstract was to present our data from 2014-2018. Methods From 2014 to 2018 (and ongoing) we have registered all patients endoscopically treated for LGD (low grade dysplasia) and superficial esophageal cancer, including some cases with T1b. The patient material, including treatment modality, histology, time of follow-up, the need for surgery and its outcome were registered. The majority of follow-ups took place at our hospital. Data was also retrieved from cases of late follow-up at other hospitals. Results 86 patients were endoscopically treated. The histology revealed LGD (24%), HGD (50%) and adenocarcinoma (21%). 15% were treated for a T1a tumor, 7% for T1b. 29% underwent endoscopic mucosal resection (EMR), 29% radiofrequency ablation (RFA) and 40% had both. The endoscopic treatment resulted in complete resolution of dysplasia in 64%, downstaging in 11%, whilst progression occurred in 11%. Five patients were operated for initial T1b or progression into T1b. The operation specimen showed no residual tumor in 3/5 patients. There were no serious complications. 90-days mortality was 1%. Conclusion Endoscopic treatment is a safe and efficient treatment option for superficial esophageal cancer. Few patients needed surgery and there was few and exclusively mild complications. This treatment modality will spare many patients for esophageal surgery with its associated high level of comorbidity.