Background: In recent years, effective outcomes of endoscopic submucosal dissection (ESD) for esophagogastric junction cancer including short-segment Barrett’s esophagus (SSBE) cancer have been reported. However, the efficacy of ESD for long-segment Barrett’s esophagus (LSBE) cancer is unknown. Aim: To clarify the treatment outcomes of ESD for LSBE cancer versus SSBE cancer. Methods: A total of 86 patients with 91 superficial Barrett’s esophageal adenocarcinomas who underwent ESD were enrolled; of these, 68 had underlying SSBE and 18 had LSBE. Procedure outcomes and prognosis were compared. Results: There was no significant difference in age and tumor diameter among patients. The only complication observed was stricture, but it was not significant (2 vs. 9%). No significant difference was observed in the negative horizontal margin rates (94.1 vs. 95.7%), R0 resection rates (83.8 vs. 82.6%), curative resection rates (72.1 vs. 73.9%), and noncurative factors. Both LSBE and SSBE cancer showed favorable 3-year overall survival rates (95.0 vs. 94.4%) in the median observation period of 28.5 months. Conclusions: ESD for LSBE cancer achieved procedure outcomes and short-term prognosis comparable to SSBE. ESD has the potential to be an effective therapeutic option for esophageal neoplasms in patients with LSBE.

1.
Sharma P, Morales TG, Sampliner RE: Short segment Barrett’s esophagus – the need for standardization of the definition and of endoscopic criteria. Am J Gastroenterol 1998; 93: 1033–1036.
2.
Koike T, Nakagawa K, Iijima K, Shimosegawa T: Endoscopic resection (endoscopic submucosal dissection/endoscopic mucosal resection) for superficial Barrett’s esophageal cancer. Dig Endosc 2013; 25(suppl 1):20–28.
3.
Pfaffenbach B, Hullerum J, Orth KH, Langer M, Stabenow-Lohbauer U, Lux G: Bile and acid reflux in long and short segment Barrett’s esophagus, and in reflux disease. Z Gastroenterol 2000; 38: 565–570.
4.
Kagemoto K, Oka S, Tanaka S, Miwata T, Urabe Y, Sanomura Y, Yoshida S, Hiyama T, Arihiro K, Chayama K: Clinical outcomes of endoscopic submucosal dissection for superficial Barrett’s adenocarcinoma. Gastrointest Endosc 2014; 80: 239–245.
5.
Chevaux JB, Piessevaux H, Jouret-Mourin A, Yeung R, Danse E, Deprez PH: Clinical outcome in patients treated with endoscopic submucosal dissection for superficial Barrett’s neoplasia. Endoscopy 2015; 47: 103–112.
6.
Höbel S, Dautel P, Baumbach R, Oldhafer KJ, Stang A, Feyerabend B, Yahagi N, Schrader C, Faiss S: Single center experience of endoscopic submucosal dissection (ESD) in early Barrett’s adenocarcinoma. Surg Endosc 2015; 29: 1591–1597.
7.
Omae M, Fujisaki J, Horiuchi Y, Yoshizawa N, Matsuo Y, Kubota M, Suganuma T, Okada K, Ishiyama A, Hirasawa T, Yamamoto Y, Tsuchida T, Hoshino E, Igarashi M: Safety, efficacy, and long-term outcomes for endoscopic submucosal dissection of early esophagogastric junction cancer. Gastric Cancer 2013; 16: 147–154.
8.
Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T, Repici A, Vieth M, De Ceglie A, Amato A, Berr F, Bhandari P, Bialek A, Conio M, Haringsma J, Langner C, Meisner S, Messmann H, Morino M, Neuhaus H, Piessevaux H, Rugge M, Saunders BP, Robaszkiewicz M, Seewald S, Kashin S, Dumonceau JM, Hassan C, Deprez PH: Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015; 47: 829–854.
9.
Phoa KN, Pouw RE, Bisschops R, Pech O, Ragunath K, Weusten BL, Schumacher B, Rembacken B, Meining A, Messmann H, Schoon EJ, Gossner L, Mannath J, Seldenrijk CA, Visser M, Lerut T, Seewald S, ten Kate FJ, Ell C, Neuhaus H, Bergman JJ: Multimodality endoscopic eradication for neoplastic Barrett oesophagus: results of an European multicentre study (EURO-II). Gut 2016; 65: 555–562.
10.
Desai M, Saligram S, Gupta N, Vennalaganti P, Bansal A, Choudhary A, Vennelaganti S, He J, Titi M, Maselli R, Qumseya B, Olyaee M, Waxman I, Repici A, Hassan C, Sharma P: Efficacy and safety outcomes of multimodal endoscopic eradication therapy in Barrett’s esophagus-related neoplasia: a systematic review and pooled analysis. Gastrointest Endosc 2017; 85: 482–495.e4.
11.
Pech O, Behrens A, May A, Nachbar L, Gossner L, Rabenstein T, Manner H, Guenter E, Huijsmans J, Vieth M, Stolte M, Ell C: Long-term results and risk factor analysis for recurrence after curative endoscopic therapy in 349 patients with high-grade intraepithelial neoplasia and mucosal adenocarcinoma in Barrett’s oesophagus. Gut 2008; 57: 1200–1206.
12.
Titi M, Overhiser A, Ulusarac O, Falk GW, Chak A, Wang K, Sharma P: Development of subsquamous high-grade dysplasia and adenocarcinoma after successful radiofrequency ablation of Barrett’s esophagus. Gastroenterology 2012; 143: 564–566.e1.
13.
Japan Esophageal Society: Japanese Classification of Esophageal Cancer, 11th Edition: part I. Esophagus 2017; 14: 1–36.
14.
Shaheen NJ, Falk GW, Iyer PG, Gerson LB; American College of Gastroenterology: ACG clinical guideline: diagnosis and management of Barrett’s esophagus. Am J Gastroenterol 2016; 111: 30–50.
15.
Sharma P, Bergman JJ, Goda K, Kato M, Messmann H, Alsop BR, Gupta N, Vennalaganti P, Hall M, Konda V, Koons A, Penner O, Goldblum JR, Waxman I: Development and validation of a classification system to identify high-grade dysplasia and esophageal adenocarcinoma in Barrett’s esophagus using narrow-band imaging. Gastroenterology 2016; 150: 591–598.
16.
Muto M, Yao K, Kaise M, Kato M, Uedo N, Yagi K, Tajiri H: Magnifying endoscopy simple diagnostic algorithm for early gastric cancer (MESDA-G). Dig Endosc 2016; 28: 379–393.
17.
Ishihara R, Oyama T, Abe S, Takahashi H, Ono H, Fujisaki J, Kaise M, Goda K, Kawada K, Koike T, Takeuchi M, Matsuda R, Hirasawa D, Yamada M, Kodaira J, Tanaka M, Omae M, Matsui A, Kanesaka T, Takahashi A, Hirooka S, Saito M, Tsuji Y, Maeda Y, Yamashita H, Oda I, Tomita Y, Matsunaga T, Terai S, Ozawa S, Kawano T, Seto Y: Risk of metastasis in adenocarcinoma of the esophagus: a multicenter retrospective study in a Japanese population. J Gastroenterol 2017; 52: 800–808.
18.
Kanda Y: Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 2013; 48: 452–458.
19.
Matsui A, Kuribayashi Y, Nomura K, Tanaka T, Toba T, Yamada A, Furuhata T, Yamashita S, Kikuchi D, Mitani T, Ogawa O, Iizuka T, Hoteya S, Kaise M: Conventional white light endoscopic features of small superficial Barrett’s esophageal adenocarcinoma. Digestion 2016; 93: 47–52.
20.
Qumseya BJ, Brown J, Abraham M, White D, Wolfsen H, Gupta N, Vennalaganti P, Sharma P, Wallace MB: Diagnostic performance of EUS in predicting advanced cancer among patients with Barrett’s esophagus and high-grade dysplasia/early adenocarcinoma: systematic review and meta-analysis. Gastrointest Endosc 2015; 81: 865–874.e2.
21.
Yoshizawa N, Fujisaki J, Omae M, Igarashi M, Tanabe S, Koizumi W: Study of the invasion depth diagnosis of superficial Barrett’s esophageal adenocarcinoma- identification of large vessels by magnifying endoscopy is useful for the diagnosis of sub mucosal cancer. Adv Res Gastroentero Hepatol 2016; 2: 1–5.
22.
Hulscher JB, van Sandick JW, de Boer AG, Wijnhoven BP, Tijssen JG, Fockens P, Stalmeier PF, ten Kate FJ, van Dekken H, Obertop H, Tilanus HW, van Lanschot JJ: Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N Engl J Med 2002; 347: 1662–1669.
23.
Probst A, Aust D, Märkl B, Anthuber M, Messmann H: Early esophageal cancer in Europe: endoscopic treatment by endoscopic submucosal dissection. Endoscopy 2015; 47: 113–121.
24.
Zemler B, May A, Ell C, Stolte M: Early Barrett’s carcinoma: the depth of infiltration of the tumour correlates with the degree of differentiation, the incidence of lymphatic vessel and venous invasion. Virchows Arch 2010; 456: 609–614.
25.
Tsujii Y, Nishida T, Nishiyama O, Yamamoto K, Kawai N, Yamaguchi S, Yamada T, Yoshio T, Kitamura S, Nakamura T, Nishihara A, Ogiyama H, Nakahara M, Komori M, Kato M, Hayashi Y, Shinzaki S, Iijima H, Michida T, Tsujii M, Takehara T: Clinical outcomes of endoscopic submucosal dissection for superficial esophageal neoplasms: a multicenter retrospective cohort study. Endoscopy 2015; 47: 775–783.
26.
Gupta M, Iyer PG, Lutzke L, Gorospe EC, Abrams JA, Falk GW, Ginsberg GG, Rustgi AK, Lightdale CJ, Wang TC, Fudman DI, Poneros JM, Wang KK: Recurrence of esophageal intestinal metaplasia after endoscopic mucosal resection and radiofrequency ablation of Barrett’s esophagus: results from a US Multicenter Consortium. Gastroenterology 2013; 145: 79–86.e1.
27.
Hoteya S, Furuhata T, Takahito T, Fukuma Y, Suzuki Y, Kikuchi D, Mitani T, Matsui A, Yamashita S, Nomura K, Kuribayashi Y, Iizuka T, Kaise M: Endoscopic submucosal dissection and endoscopic mucosal resection for non-ampullary superficial duodenal tumor. Digestion 2017; 95: 36–42.
28.
Terheggen G, Horn EM, Vieth M, Gabbert H, Enderle M, Neugebauer A, Schumacher B, Neuhaus H: A randomised trial of endoscopic submucosal dissection versus endoscopic mucosal resection for early Barrett’s neoplasia. Gut 2017; 66: 783–793.
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