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  • 1. Aims and Scope

    Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE

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    Editor-in-Chief
    Yong Chan Lee Professor of Medicine
    Director, Gastrointestinal Research Laboratory
    Veterans Affairs Medical Center, Univ. California San Francisco
    San Francisco, USA

    Deputy Editor

    Deputy Editor
    Jong Pil Im Seoul National University College of Medicine, Seoul, Korea
    Robert S. Bresalier University of Texas M. D. Anderson Cancer Center, Houston, USA
    Steven H. Itzkowitz Mount Sinai Medical Center, NY, USA
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    All papers submitted to Gut and Liver are reviewed by the editorial team before being sent out for an external peer review to rule out papers that have low priority, insufficient originality, scientific flaws, or the absence of a message of importance to the readers of the Journal. A decision about these papers will usually be made within two or three weeks.
    The remaining articles are usually sent to two reviewers. It would be very helpful if you could suggest a selection of reviewers and include their contact details. We may not always use the reviewers you recommend, but suggesting reviewers will make our reviewer database much richer; in the end, everyone will benefit. We reserve the right to return manuscripts in which no reviewers are suggested.

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Long-term Outcomes and Factors Affecting the Survival of Patients with Mucosal Esophageal Squamous Cell Carcinoma

Ga Hee Kim1 , Hee Kyong Na1 , Ji Yong Ahn1 , Jeong Hoon Lee1 , Kee Wook Jung1 , Do Hoon Kim1 , Hyeong Ryul Kim2 , Kee Don Choi1 , Ho June Song1 , Yong-Hee Kim2 , Gin Hyug Lee1 , Hwoon-Yong Jung1 , and Seung-Il Park2

Departments of 1Gastroenterology and 2Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Correspondence to:Ho June Song
ORCID https://orcid.org/0000-0002-3195-8794
E-mail hjsong@amc.seoul.kr
Yong-Hee Kim
ORCID https://orcid.org/0000-0002-3195-8794
E-mail kimyh67md@hotmail.com

Received: August 6, 2020; Revised: October 6, 2020; Accepted: October 7, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Gut and Liver

Published online January 19, 2021

Copyright © Gut and Liver.

Abstract

Background/Aims: Data regarding the prognosis of early esophageal cancer are lacking. This study investigated the long-term outcomes and factors affecting the survival of patients with mucosal esophageal squamous cell carcinoma (T1aESCC).
Methods: We analyzed the clinical and tumor-specific parameters of 263 patients who received surgical resection (SR; n=63) or endoscopic resection (ER; n=200) for T1aESCC. Underlying comorbidities were scored using the Charlson Comorbidity Index (CCI). Overall survival (OS) was the primary outcome, and multivariate regression analysis was performed to predict factors for OS.
Results: Of the study patients (age, 64.5±8.0 years), the CCI was 1.0±1.4 in the ER group and 0.6±0.9 in the SR group (p=0.107). The 5-year OS rate during follow-up (54.4±20.4 months) was 85.7% (ER group, 86.8%; SR group, 82.4%; p=0.631). The cumulative 5-year incidence of esophageal cancer recurrence was 10.5% in the ER group (vs 0% in the SR group). The overall mortality rate was 12.9% (12.0% in the ER group and 15.9% in the SR group; p=0.399). The most common cause of mortality was second primary cancers in the ER group (75%) and organ dysfunction or postoperative complications in the SR group (70%). According to multivariate analysis, only CCI was significantly associated with OS (p<0.001). The 5-year OS rate in patients with a CCI >2 and in those with a CCI ≤2 was 60.2% and 88.2%, respectively (p<0.001). The treatment method (ER vs SR) was not a significant affecting factor (p=0.238).
Conclusions: The long-term prognosis of patients with T1aESCC was significantly associated with underlying comorbidities.

Keywords: Esophagus, Squamous cell carcinoma, Endoscopic mucosal resection, Esophagectomy, Prognosis


Article

ahead

Gut and Liver

Published online January 19, 2021

Copyright © Gut and Liver.

Long-term Outcomes and Factors Affecting the Survival of Patients with Mucosal Esophageal Squamous Cell Carcinoma

Ga Hee Kim1 , Hee Kyong Na1 , Ji Yong Ahn1 , Jeong Hoon Lee1 , Kee Wook Jung1 , Do Hoon Kim1 , Hyeong Ryul Kim2 , Kee Don Choi1 , Ho June Song1 , Yong-Hee Kim2 , Gin Hyug Lee1 , Hwoon-Yong Jung1 , and Seung-Il Park2

Departments of 1Gastroenterology and 2Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Correspondence to:Ho June Song
ORCID https://orcid.org/0000-0002-3195-8794
E-mail hjsong@amc.seoul.kr
Yong-Hee Kim
ORCID https://orcid.org/0000-0002-3195-8794
E-mail kimyh67md@hotmail.com

Received: August 6, 2020; Revised: October 6, 2020; Accepted: October 7, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims: Data regarding the prognosis of early esophageal cancer are lacking. This study investigated the long-term outcomes and factors affecting the survival of patients with mucosal esophageal squamous cell carcinoma (T1aESCC).
Methods: We analyzed the clinical and tumor-specific parameters of 263 patients who received surgical resection (SR; n=63) or endoscopic resection (ER; n=200) for T1aESCC. Underlying comorbidities were scored using the Charlson Comorbidity Index (CCI). Overall survival (OS) was the primary outcome, and multivariate regression analysis was performed to predict factors for OS.
Results: Of the study patients (age, 64.5±8.0 years), the CCI was 1.0±1.4 in the ER group and 0.6±0.9 in the SR group (p=0.107). The 5-year OS rate during follow-up (54.4±20.4 months) was 85.7% (ER group, 86.8%; SR group, 82.4%; p=0.631). The cumulative 5-year incidence of esophageal cancer recurrence was 10.5% in the ER group (vs 0% in the SR group). The overall mortality rate was 12.9% (12.0% in the ER group and 15.9% in the SR group; p=0.399). The most common cause of mortality was second primary cancers in the ER group (75%) and organ dysfunction or postoperative complications in the SR group (70%). According to multivariate analysis, only CCI was significantly associated with OS (p<0.001). The 5-year OS rate in patients with a CCI >2 and in those with a CCI ≤2 was 60.2% and 88.2%, respectively (p<0.001). The treatment method (ER vs SR) was not a significant affecting factor (p=0.238).
Conclusions: The long-term prognosis of patients with T1aESCC was significantly associated with underlying comorbidities.

Keywords: Esophagus, Squamous cell carcinoma, Endoscopic mucosal resection, Esophagectomy, Prognosis

Gut and Liver

Vol.15 No.3
May, 2021

pISSN 1976-2283
eISSN 2005-1212

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