ArticleUnited European gastroenterology journal2021
Endoscopic resection of Barrett's adenocarcinoma: Intramucosal and low-risk tumours are not associated with lymph node metastases.
Article in United European gastroenterology journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Clinical practice guidelines for esophagogastric junction cancer: Upper GI Oncology Summit 2023.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2024Guideline
- Review
- Review
- Outcomes after radical endoscopic resection of high risk T1 esophageal adenocarcinoma: an international multicenter retrospective cohort study.Endoscopy · 2025Article
- Endoscopic Resection of Malignancies in the Upper GI Tract: A Clinical Algorithm.Visceral medicine · 2024Review
- Barrett's Esophagus: An Updated Review.Diagnostics (Basel, Switzerland) · 2023Review
- Endoscopic submucosal dissection for early esophagogastric junction adenocarcinomas: a systematic review.Annals of gastroenterologyArticle
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Authors and funding
18 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSuperficial oesophageal adenocarcinoma can be resected endoscopically, but data to define a curative endoscopic resection are scarce.
objectiveOur study aimed to assess the risk of lymph node metastasis depending on the depth of invasion and histological features of oesophageal adenocarcinoma.
methodsWe retrospectively included all patients undergoing an endoscopic resection for T1 oesophageal adenocarcinoma among seven expert centres in France in 2004-2016. Mural invasion was defined as either intramucosal or submucosal tumours; the latter were further divided into superficial submucosal (<1000 mm) and deep submucosal (>1000 mm). Absence or presence of lymphovascular invasion and/or poorly differentiated cancer (G3) defined a low-risk or a high-risk tumour, respectively. For submucosal tumours, invasion depth and histological features were systematically confirmed after a second dedicated histological assessment (new 2-mm thick slices) performed by a second pathologist. Occurrence of lymph node metastasis was recorded during the follow-up from histological or PET CT reports when an invasive procedure was not possible.
resultsIn total, 188 superficial oesophageal adenocarcinomas were included with a median follow-up of 34 months. No lymph node metastases occurred for intramucosal oesophageal adenocarcinomas (n = 135) even with high-risk histological features. Among submucosal oesophageal adenocarcinomas, only tumours with lymphovascular invasion or poorly differentiated cancer or with a depth of invasion >1000 μm developed lymph node metastasis tumours (n = 10/53%; 18.9%; hazard ratio 12.04). No metastatic evolution occurred under a 1000-mm threshold for all low-risk tumours (0/25), nor under 1200 mm (0/1) and three over this threshold (3/13%, 23.1%).
conclusionIntramucosal and low-risk tumours with shallow submucosal invasion up to 1200 mm were not associated with lymph node metastasis during follow-up. In case of high-risk features and/or deep submucosal invasion, endoscopic resections are not sufficient to eliminate the risk of lymph node metastasis, and surgical oesophagectomy should be carried out. These results must be confirmed by larger prospective series.
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