Early XXXX in Europe: endoscopic treatment by endoscopic submucosal dissection.

@entity1 @entity957 @entity420 @entity418
Background and study aims: Endoscopic resection is the standard treatment for superficial @entity418 . Data on early @entity420 (EAC) are widely restricted to endoscopic mucosal resection (EMR), whereas large studies have been published on endoscopic submucosal dissection (ESD) for @entity957 ( @entity957 ). ESD has potential advantages regarding en bloc and R0 resection rates, which have been demonstrated for @entity957 . However, studies have failed to confirm these advantages in EAC. The aim of this study was to investigate the efficacy of ESD in early @entity418 . @entity1 and methods: A total of 111 early @entity418 (87 EACs and 24 ESCCs) were resected by ESD at a German tertiary referral center. A total of 60 EACs were resected within Barrett's segments  <=M3. Resection rates, complications, and follow-up data were recorded prospectively. Results: En bloc resection rates were 95.4% for EAC and 100% for @entity957 (P=0.575), and R0 resection rates were 83.9% and 91.7%, respectively (P=0.515). The R0 resection rate was higher in Barrett's  <=M3 vs. >M3 (90% vs. 70.4%; P=0.029). The curative resection rate was 72.4% for EAC vs. 45.8% for @entity957 (P=0.026). Endoluminal recurrence was observed in 2.4% of EACs (8% in Barrett's >M3, 0% in Barrett's  <=M3), and 0% of ESCCs. Complications included strictures (11.7%) and bleedings (0.9%), but no perforation. Disease-specific survival was 97.7% (EAC) and 95.8% ( @entity957 ), and overall survival was 96.6% (EAC) and 66.7% ( @entity957 ) over a mean follow-up period of 24.3 months and 38.0 months, respectively. Conclusions: ESD was shown to be a safe resection method, achieving high R0 resection rates in both EAC and @entity957 . Recurrence rates were low. To improve R0 resection within long Barrett's segments, diagnosis of the lateral extension of the lesion needs to be improved.
