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Argon plasma coagulation for superficial squamous cell carcinoma in the residual esophagus after esophagectomy

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Abstract

Background

Patients after esophagectomy for esophageal squamous cell carcinoma (SCC) occasionally develop metachronous SCC in the residual esophagus. Although most of these second primary lesions are detected as superficial cancer at follow-up endoscopy, it is often difficult to perform endoscopic resection for these lesions near the site of anastomosis.

Methods

The objective of this study was to evaluate the effectiveness of argon plasma coagulation (APC) for superficial SCC in the residual esophagus after esophagectomy. Twelve patients (involving 15 s primary lesions) received APC for superficial SCC in the residual esophagus after esophagectomy. These lesions were difficult to perform endoscopic resection and they were treated using APC.

Results

There was no treatment-related complication. Complete remission (CR) was achieved in 13 (86.6%) of the 15 lesions: CR was achieved in 11 lesions (73.3%) after the first APC course, and in another 2 lesions (13.3%) after two or more APC courses. Of the 2 patients with persisting residual tumor, 1 patient received 12 times repeated-APC courses over 6 years, and eventually achieved local control without metastasis, the other patient received radiotherapy and cervical esophagectomy after treatment failure with APC. All patients survived except for one patient who died of old age and another patient who died of tongue cancer.

Conclusions

APC was a safe treatment that was easy to perform. APC was concluded to be an effective treatment for superficial SCC in the residual esophagus after esophagectomy when endoscopic resection was difficult.

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Acknowledgements

The authors thank Dr. Paul Kawachi at Open Education Network kawachi@open-ed.net, for English proofreading.

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Authors and Affiliations

  1. Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka, 830-0011, Japan

    Kohei Saisho, Toshiaki Tanaka, Satoru Matono, Naoki Mori, Haruhiro Hino, Kazutaka Kadoya, Ryosuke Nishida, Masahiro Fujisaki, Fumihiko Fujita & Yoshito Akagi

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  1. Kohei Saisho
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  2. Toshiaki Tanaka
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  3. Satoru Matono
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  4. Naoki Mori
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  5. Haruhiro Hino
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  6. Kazutaka Kadoya
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  7. Ryosuke Nishida
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  8. Masahiro Fujisaki
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  9. Fumihiko Fujita
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  10. Yoshito Akagi
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Correspondence to Kohei Saisho.

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Ethical Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

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The authors declare that they have no conflict of interests.

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Informed consent was obtained from all patients for being included in the study.

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Saisho, K., Tanaka, T., Matono, S. et al. Argon plasma coagulation for superficial squamous cell carcinoma in the residual esophagus after esophagectomy. Esophagus 17, 448–455 (2020). https://doi.org/10.1007/s10388-020-00733-w

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