Recurrence after endoscopic mucosal resection for superficial esophageal cancer

Background and Study Aims: We present the results of endoscopic mucosal res ection (EMR) for superficial esophageal cancer in patients treated at the N ational Cancer Center Hospital East since March 1993, and discuss the facto rs involved in local recurrence. Patients and Methods: The study consisted of 51 patients with a total of 57 superficial esophageal cancers which were treated by EMR at the National C ancer Center Hospital East between March 1993 and March 1998. EMR was perfo rmed with a two-channel fiberscope or with the assistance of the endoscopic esophageal mucosal resection tube. Follow-up examinations by means of endo scopy with iodine staining and biopsy were repeated every 3-6 months. Results: A total of 19 patients had double cancers; 12 had head and neck ca ncers (HNC), six had stomach cancers, and one had lung cancer. The patients with HNC tended to have multiple iodine-unstained areas, and multiple canc ers in the esophagus. Local recurrence was detected in two out of five pati ents (40%) with multiple esophageal cancers, and in two out of 46 patients (4%) with solitary cancer (P=0.0433). There was no difference in the rate o f local recurrence between patients with HNC and those without HNC, Three o ut of four patients with recurrent cancers were given additional treatment. EMR for two and radiotherapy alone for one; no further recurrence occurred except in the patient who underwent radiotherapy alone. Conclusions: Multiplicity of cancer is a risk factor for local recurrence. Appropriate additional treatment should be indicated for recurrent lesions.