‘Organ-Sparing’ Endoscopy Procedure shown to be as effective as Oesophagus Removal in Cancer Patients

A minimally invasive endoscopy technique is a viable alternative to major surgery, according to research published this month.  Conventionally, even early stage oesophageal cancer has been treated using a major surgical procedure known as esophagectomy, whereby the oesophagus is removed and remodelled from the stomach.  The use of endoscopic mucosal resection allows cancerous lesions to be removed less invasively, allowing the integrity of the oesophagus to be maintained, with fewer risks for the patient.

Although the benefits of endoscopy have been acknowledged, until now there have been few population-based studies comparing the long-term outcomes of patients treated with this endoscopic procedure versus major surgery.  Using a National Cancer Institute database, researchers at the Mayo Clinic in Florida compared survival rates in 1618 cancer patients suffering from superficial oesophageal adenocarcinoma between 1998 and 2009.  The findings, published in Clinical Gastroenterology and Hepatology, showed that overall five year survival rates were not significantly different for patients treated with endoscopy versus surgical resection.  The study, led by Dr Michael Wallace, also showed that this endoscopic procedure is increasingly being used as an alternative to major surgery, from just 3% of cases in 1998 to 29% in 2009.

The lower risk associated with endoscopy as opposed to major surgery, and the improved quality of life following treatment, may have contributed to the trend towards the wider use of this technique.  The finding that endoscopic mucosal resection does not appear to compromise patient survival will reassure both patients and doctors that it should be the method of choice for treating early stage oesophageal cancers when possible.  Given that oesophageal cancer has the most rapidly increasing incidence in the developing world, the findings surrounding this ‘organ-sparing’ treatment are particularly timely and are in line with the current trend towards minimally invasive procedures.

More information at: http://www.mayoclinic.org/news2013-jax/7763.html