323. LONG-TERM SURVIVAL OUTCOME OF PATIENTS WITH EARLY ESOPHAGEAL CANCER AFTER ESD (ENDOSCOPIC SUBMUCOSAL DISSECTION) AND ESOPHAGECTOMY

Abstract Endoscopic submucosal dissection (ESD) has been gradually accepted as an effective treatment option for patients with early esophageal cancer. However, its long-term outcome is limited in literature. Method This study compare the overall survival for the patients with early esophageal cancer (T1N0M0) treated with ESD and esophagectomy. The tumor staging was confirmed with EUS, PET and CT imaging. The indication of ESD was T1aN0M0 in clinical staging studies. Three-field lymph node dissection with intrathoracic (Ivor Lewis) or cervical esophagogastrostomy (McKeown) was performed for the patients undergoing esophagectomy under thoracoscopic (minimally invasive esophagectomy) laparoscopic approaches. Result There were 82 patients enrolled in the study including 22 and 60 undergoing esophagectomy and ESD respectively. There is no difference of overall survival in 3 and 5 years with 89.1 % and 81.8 % for patients after ESD, 78.1 % and 78.1 % after esophagectomy (P=0.6) Conclusion For early esophageal cancer with T1aN0M0, ESD can provide an equivalent long-term survival outcome as compared to that with esophagectomy with three-field lymph node dissection.