Endoscopic piecemeal mucosal resection of early esophageal cancer and precancerous lesions: a retrospective study

Abstract

Objective To investigate the technical feasibility and oncological safety of EPMR for early esophageal cancer and precancerous lesions. Methods Clinicopathological data, procedure quality and complications of 70 patients with early esophageal cancer or precancerous lesions were retrospectively analysed. The technical safety and feasibility were assessed, and the complications were investigated through postoperative surveillance. The results were compared with published data from two high-quality meta-analysis studies on ESD. Results In a total of 70 patients who underwent EPMR, 35.7%(25/70) were diagnosed as having early esophageal cancer and 64.3%(45/70) atypical hyperplasia. And tumor size greater than 2 cm was 78.6%(55/70). The mean EPMR time was(28.31±9.49) minutes. The R0 resection rate of EPMR was 88.6%(62/70) and no perforation occurred. The bleeding rate was 21.4%(15/70). The esophageal stricture rate was 1.4%(1/70). The recurrence rate was 2.9%(2/70). Compared with published ESD data from the two studies, EPMR showed shorter procedure time, lower curative rate and lower rates of stricture and perforation, but slightly higher rates of bleeding and recurrence. Conclusion Both EPMR and ESD are feasible and effective for early esophageal cancer and precancerous lesions. The curative results of EPMR are similar to ESD, with shorter procedure time, but higher bleeding and recurrence rates. Key words: Early esophageal cancer; Esophageal precancerous lesions; Endoscopic piecemeal mucosal resection; Endoscopic submucosal dissection