Researchers have found that early stage cancers of the esophagus can be treated as effectively by less-invasive, organ-sparing endoscopic therapy as compared to more complex surgical removal of the esophagus, according to a Mayo Clinic study published in the September 2009 issue of Gastroenterology.
In 20 percent of esophageal cancer (http://www.mayoclinic.org/esophageal-cancer) cases in the United States, the cancer is detected in the early stages," says Ganapathy Prasad, M.D., (http://www.mayoclinic.org/bio/12948837.html) gastroenterologist and lead author on the study. "Traditionally, esophageal cancer patients undergo a complicated surgery to remove the esophagus. 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."
In this study of 178 patients with early-stage esophageal adenocarcinoma, 132 (74 percent) were treated with endoscopic mucosal resection and 46 (26 percent) were treated surgically. The endoscopic mucosal resection patients underwent a procedure where a liquid is injected under the lesion and then an endoscope is used to shave off the lesions. The other patients underwent more traditional esophagectomy or removal of the esophagus.
In following these patients for nine years, both groups had a comparable overall mortality rate of approximately 20 percent. Cancer recurred in 12 percent of patients treated endoscopically, but recurrence could be re-treated endoscopically.
Dr. Prasad explains that esophagectomy surgery patients are typically in the hospital for a week, and 30 to 50 percent of patients have complications post surgery. For example, patients whose esophagus has been removed face lifelong dietary restrictions. Endoscopic treatments, however, are performed in an outpatient care setting, and patients can eat full meals in a couple of days.
"If patients do choose to proceed to surgery, they should be advised to seek out a high-volume surgical center," says Kenneth Wang, M.D., (http://www.mayoclinic.org/bio/10031251.html) gastroenterologist and senior researcher on the study. "Research has shown that high-volume hospitals, such as Mayo Clinic, have better survival rates and outcomes for patients."
The Mayo Clinic Barrett's Esophagus Unit (http://www.mayoclinic.org/barretts-esophagus/rsttreatment.html) offers a multidisciplinary approach to evaluate early symptoms, devise a surveillance schedule and perform all tests and medical and surgical treatments.
Esophageal cancer arising from Barrett's esophagus is increasing in frequency faster than any other cancer in the United States, and the tumor is lethal. Ninety percent of patients die within five years of diagnosis. About 10 percent of patients with chronic acid reflux develop the tissue changes characteristic of Barrett's esophagus, which can lead to cancer.
Dr. Wang says that future research in this area will examine genetic markers to help determine the best course of treatment for esophageal cancer patients. In addition, the Mayo research team hopes to study the use of endoscopic therapy for more advanced esophageal cancers.
Mayo Clinic's Division of Gastroenterology and Hepatology (http://www.mayoclinic.org/gi/) has been ranked #1 in the U.S. News & World Report Honor Roll of Top Hospitals since the rankings began 20 years ago.
Other members of the Mayo research team included Tsung-Teh Wu, M.D., Ph.D.; (http://www.mayoclinic.org/bio/12139416.html) ; Dennis Wigle, M.D., Ph.D. (http://www.mayoclinic.org/bio/14807335.html/); Navtej Buttar, M.D., (http://www.mayoclinic.org/bio/12404888.html); Louis-Michel Wongkeesong, M.D., Kelly Dunagan, Lori Lutzke and Lynn Borkenhagen.
About Mayo Clinic
Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. Doctors from every medical specialty work together to care for patients, joined by common systems and a philosophy of "the needs of the patient come first." More than 3,300 physicians, scientists and researchers and 46,000 allied health staff work at Mayo Clinic, which has sites in Rochester, Minn., Jacksonville, Fla., and Scottsdale/Phoenix, Ariz. Collectively, the three locations treat more than half a million people each year. To obtain the latest news releases from Mayo Clinic, go to www.mayoclinic.org/news. For information about research and education, visit www.mayo.edu. MayoClinic.com (www.mayoclinic.com) is available as a resource for your health stories.
Amy Tieder | EurekAlert!
Further reports about: > Gastroenterology > cancer patients > early stage > endoscopic mucosal resection > endoscopic therapy > esophageal cancer > esophagectomy surgery > genetic marker > high-volume surgical center > less-invasive therapy > multidisciplinary approach > organ-sparing endoscopic therapy > surgical treatments
Laser activated gold pyramids could deliver drugs, DNA into cells without harm
24.03.2017 | Harvard John A. Paulson School of Engineering and Applied Sciences
What does congenital Zika syndrome look like?
24.03.2017 | University of California - San Diego
Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.
The results will be published on March 22 in the journal „Astronomy & Astrophysics“.
Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...
Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.
Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...
In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...
20.03.2017 | Event News
14.03.2017 | Event News
07.03.2017 | Event News
24.03.2017 | Materials Sciences
24.03.2017 | Physics and Astronomy
24.03.2017 | Physics and Astronomy