From Our 2009 Archives

New Therapy Spares Organ in Early Esophageal Cancer

TUESDAY, Sept. 1 (HealthDay News) -- Early-stage cancers of the esophagus can be treated effectively by less invasive, organ-sparing endoscopic therapy, a new study has found.

This is good news, as esophageal cancer arising from Barrett's esophagus is increasing in frequency faster than any other cancer in the United States, and 90% of patients die within five years of being diagnosed, according to a news release from the Mayo Clinic.

Esophageal cancer is diagnosed in its early stages about 20% of the time, Dr. Ganapathy Prasad, of the department of gastroenterology and hepatology at the Mayo Clinic and lead author on the study, published in the September issue of Gastroenterology.

"Traditionally, esophageal cancer patients undergo a complicated surgery to remove the esophagus," Prasad said in the news release. "Our team compared surgery to the use of endoscopic therapy, where a scope is inserted in the esophagus and the cancer cells are shaved off. Our results showed the less invasive therapy was just as effective as surgery for early-stage cancers."

The study included 178 patients with early-stage esophageal adenocarcinoma; 132 were treated with endoscopic mucosal resection and 46 were treated surgically. The patients who underwent the less invasive procedure -- endoscopic mucosal resection -- had a liquid injected under the lesion and then an endoscope was used to shave off the lesions. The other patients underwent the traditional removal of the esophagus, or esophagectomy.

After a nine-year follow-up, both groups had an overall mortality rate of about 20%. Among patients treated endoscopically, cancer recurred in 12%, but recurrence could be re-treated endoscopically.

While the overall results are similar, there is no contest when the impact on patients is compared, the study authors noted. Esophagectomy surgery patients typically are in hospitalized for a week, and up to 50% of patients have complications after the surgery. In addition, patients whose esophagus has been removed face lifelong dietary restrictions.

On the other hand, endoscopic treatments are performed in an outpatient setting, and patients are allowed to eat full meals within days of the procedure, the researchers explained.

-- Dennis Thompson

SOURCE: Mayo Clinic, news release, Sept. 1, 2009

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