Minimally-Invasive Treatment Found Effective for Esophageal Cancer

A new study has found that organ-sparing endoscopic therapy for early stage cancers of the esophagus is as effective as more complex surgical removal of the esophagus.

Researchers from the Mayo Clinic (Rochester, MN, USA) followed 178 patients with early-stage esophageal adenocarcinoma (EAC) between 1998 and 2007. The patients were divided into an endoscopically treated (ENDO) group, which included 132 patients (74%) treated with endoscopic mucosal resection, and a surgically treated (SURG) group, which included 46 patients (26%) that were treated via traditional esophagectomy. Vital status information was queried using an institutionally approved internet research and location service. Statistical analysis was performed using Kaplan-Meier curves and Cox proportional hazard ratios.

The researchers found that after a mean follow-up period of 64 months in the SURG group and 43 months the ENDO group, the cumulative mortality in the ENDO group (17%) was comparable with the SURG group (20%), as was overall survival, demonstrating that the treatment modality was not a significant predictor of survival. Recurrent carcinoma was detected in 12% of patients in the ENDO group, all successfully re-treated without impact on overall survival. The study was published in the September 2009 issue of the journal Gastroenterology.

"Traditionally, esophageal cancer patients undergo a complicated surgery to remove the esophagus,” said lead author gastroenterologist Ganapathy Prasad, M.D. "Our team compared surgery to the use of endoscopic therapy, where a scope is inserted in the esophagus and the cancer cells are shaved off. Our results showed the less-invasive therapy was just as effective as surgery for early-stage cancers.”

Dr. Prasad added that esophagectomy surgery patients are typically in the hospital for a week, and 30-50% of the patients experience complications post surgery, as well as being prescribed lifelong dietary restrictions. Endoscopic treatments, however, are performed in an outpatient care setting, and patients can eat full meals in a couple of days.

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