Posts Tagged ‘endoscopic’

Minimally invasive, high-performance intervention for staging lung cancer

Endoscopic biopsy of the lymph nodes is a minimally invasive, non-surgical intervention that has recently begun to be used to stage lung cancer. The study conducted by Dr. Liberman’s team involved 166 patients with confirmed or suspected non small cell lung cancer, and was designed to compare the new approach to surgical staging under general anesthesia, as prescribed in current guidelines for this type of cancer. The findings, which were recently published in CHEST Journal, the official publication of the American College of Chest Physicians, show that the endoscopy approach is not only sensitive and accurate, but also leads to improved staging compared to surgical staging due to its ability to biopsy lymph nodes and metastases not attainable with surgical techniques.

Research protocol

All patients underwent endobronchial ultrasound (EBUS), endoscopic ultrasound (EUS) and surgical mediastinal staging (SMS) during a single procedure. Each subject served as his or her own control. The results of the EBUS, EUS and combined EBUS/EUS were compared to SMS (gold standard) results and, in patients with negative lymph node staging, to lymph node sampling at pulmonary resection.

source : http://www.sciencedaily.com/releases/2014/09/140904141807.htm

Less-invasive option as effective as esophagus removal in early esophageal cancer

It found that endoscopic therapy offered long-term survival rates similar to those for esophagectomy, says lead author, Michael B. Wallace, M.D., a gastroenterologist at Mayo Clinic in Florida.

"Endoscopic resection in the esophagus is similar to how we remove polyps in the colon, although it is much more technically complex. Esophagectomy is a major surgical procedure that cuts out the entire esophagus, and pulls the stomach into the neck to create a new food tube," Dr. Wallace says.

"Our study on national outcomes, as well as our own experience with the procedure at Mayo Clinic in Florida, suggests that both offer the similar changes for cure and long-term survival," he says. "Patients now have the option to preserve their esophagus when only early stage cancer is present."

The research looked at national outcomes from the two procedures in patients with esophageal adenocarcinoma, the most common type of esophageal cancer in the United States. The research team examined data from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database.

They identified 1,619 patients with superficial, early stage esophageal adenocarcinoma who had endoscopic therapy (19 percent) or surgery (81 percent) from 1998 through 2009. Many of these patients were treated for cancers that arose from Barrett’s esophagus, a condition in which the cells in the lower part of the esophagus morph into a precancerous state.

The researchers collected survival data through the end of 2009, and found that endoscopy therapy increased progressively — from 3 percent in 1998 to 29 percent in 2009 — and was more often used in older patients. After adjusting for patient and tumor factors, the researchers concluded that patients treated by endoscopy had similar overall survival times compared to surgery.

"Endoscopy therapy for early stage esophageal cancer is becoming an acceptable method for all patients with very early esophageal cancer," Dr. Wallace says. He adds that because of its complexity the procedure is generally offered at centers of endoscopic excellence, such as Mayo Clinic in Florida, that have extensive experience in a multidisciplinary approach to endoscopic therapy.

source : http://www.sciencedaily.com/releases/2013/11/131107154616.htm