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Endoscopy as Effective as Surgery for Esophageal Cancer

Overall survival similar for endoscopic and surgical removal of early-stage cancer

THURSDAY, Sept. 3 (HealthDay News) -- Early-stage esophageal cancer can be removed through an endoscope rather than removing the whole esophagus, with no apparent effect on survival, according to a study in the September issue of Gastroenterology.

Ganapathy A. Prasad, M.D., and colleagues from the Mayo Clinic College of Medicine in Rochester, Minn., retrospectively compared the long-term outcomes of 176 patients with mucosal (T1a) esophageal adenocarcinoma, where 74 percent had been treated endoscopically (removing cancerous cells through an endoscope) and 26 percent had been treated surgically (removal of the esophagus).

After a mean follow-up of 43 months in the endoscopy group and 64 months in the surgery group, the researchers found that the two groups had similar cumulative mortality (17 and 20 percent, respectively) and five-year overall survival (83 and 95 percent, respectively). Treatment method had no impact on overall survival after taking other relevant factors into account. Although 12 percent of patients in the endoscopy group had recurrent cancer, this was re-treated endoscopically with no effect on overall survival.

"Overall survival in patients with mucosal esophageal adenocarcinoma when treated endoscopically appears to be comparable with that of patients treated surgically," Prasad and colleagues conclude. "Recurrent carcinoma occurs in a limited proportion of patients, but can be managed endoscopically."

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