Original articleClinical endoscopyEndoscopic spray cryotherapy for esophageal cancer: safety and efficacy
Section snippets
Subjects
Patients treated with low-pressure liquid nitrogen endoscopic spray cryotherapy (CryoSpray Ablation System, CSA Medical, Baltimore, Md) at 10 institutions were enrolled. Site data were collected retrospectively. Eligible patients included those with esophageal carcinoma, either adenocarcinoma or squamous cell carcinoma, who received 1 or more treatments with endoscopic spray cryotherapy with either curative or palliative intent. Tumors were staged by EUS and/or endoscopic resection. The goal of
Results
Seventy-nine subjects were enrolled at the participating institutions, with 49 of them eligible for efficacy analysis (Table 1). No patients were lost to follow-up. Median age was 76 years (range 51-93 years, IQR 17), 81% were male, and the histology finding was adenocarcinoma in 94% of patients. The mean (SD) tumor length treated was 4.0 (3.4) cm, with the longest segment measuring 15 cm. The median number of treatments per subject was 3 (range 1-25, IQR 3). Tumor stage included T1–60 (76%),
Discussion
Endoscopic management of superficial esophageal cancer is becoming more common because of the increasing incidence of this disease and the lack of suitability of esophagectomy in the high-risk population in which it is often diagnosed.7, 8 Recent studies comparing survival rates with endoscopic and surgical management have shown comparable results in both population-based studies9 and centers with specialized expertise in managing this condition.7, 8 A recent decision analysis suggests that
Acknowledgment
The authors thank Mark Flasar, M.D., M.S. for statistical assistance.
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DISCLOSURE:The following authors disclosed financial relationships relevant to this publication: B.D. Greenwald: Research grant from, consultant for, and advisory committee member of CSA Medical. J.A. Dumot: Research grant from and advisory committee member of CSA Medical. C.J. Lightdale: Advisory committee member of CSA Medical. N.J. Shaheen: Research grant from, consultant for, and advisory committee member of CSA Medical; research grant from BÂRRX Medical Inc; research grant from, consultant for, and speaker for Proctor & Gamble; research grant from Oncoscope Inc; research grant from and consultant for Takeda Pharmaceuticals. All other authors disclosed no financial relationships relevant to this publication. CSA Medical supported this study through a grant for statistical analysis and by assisting in data collection at some sites. CSA Medical had no role in study design, analysis, interpretation of the data, or in writing the report.