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. 2025 May 5;6(1):e70102.
doi: 10.1002/deo2.70102. eCollection 2026 Apr.

Clinical backgrounds and outcomes of patients with Barrett's esophageal adenocarcinoma treated via endoscopic submucosal dissection in Kyushu, Japan: A retrospective multicenter cohort study

Fumisato Sasaki  1 , Kazuhiro Mizukami  2 , Taro Akashi  3 , Naoyuki Yamaguchi  3 , Ryosuke Gushima  4 , Hideaki Miyamoto  4 , Shohei Uehara  1 , Yoichiro Ono  5 , Takashi Hisabe  5 , Yuzuru Kinjo  6 , Yuichiro Nasu  7 , Kensuke Fukuda  2 , Taisuke Inada  8 , Yorinobu Sumida  8 , Takashi Akutagawa  9 , Tadashi Miike  10 , Sho Suzuki  10 , Hiroki Fukuya  11 , Michita Mukasa  12 , Mitsuru Esaki  13 , Shinsuke Kumei  14 , Yosuke Minoda  15 , Tetsu Kinjo  16 , Daisuke Yamaguchi  17   18 , Yoshio Fukuda  19 , Kazutoshi Hashiguchi  20 , Hiroki Yano  21 , Hiroshi Fujita  22 , Ryo Shimoda  9 ; GI‐Kysuhu study group
Affiliations

Clinical backgrounds and outcomes of patients with Barrett's esophageal adenocarcinoma treated via endoscopic submucosal dissection in Kyushu, Japan: A retrospective multicenter cohort study

Fumisato Sasaki et al. DEN Open. .

Abstract

Objectives: Most esophageal cancers in Japan are squamous cell carcinomas; however, there has been some concern regarding a recent increase in Barrett's esophageal adenocarcinoma (BEA). This study aimed to clarify the clinical characteristics and outcomes of patients treated via endoscopic submucosal dissection (ESD) in Kyushu, including changes over time.

Methods: This multicenter, retrospective, observational study was conducted among 21 institutes situated in Kyushu. Data from patients who underwent ESD for BEA or esophageal squamous cell carcinoma between January 2010 and December 2023 were extracted from the pathology database and reviewed.

Results: The total number of esophageal ESD cases increased from 2299 over the first 7 years to 4009 over the second seven. The incidence of BEA increased from 3.6% (86/2299) over the earlier period to 4.7% (197/4009; p = 0.034) over the latter. We analyzed data from 283 patients (287 lesions). Smaller tumor-sized lesions were detected over the latter period (14.2 ± 11.6 vs. 11.2 ± 9.5 cm2, p = 0.022), significantly reducing treatment times (122.1 ± 81.2 vs. 93.2 ± 53.3 min p < 0.001). The procedure was safe, with low incidence rates, over both the earlier and later periods (respectively), of perforation (0% vs. 1.0%), delayed bleeding (1.2% vs. 2.0%), and pneumonia (4.7% vs. 4.6%).

Conclusion: The proportion of esophageal ESD procedures to treat BEA has increased in Japan's Kyushu region. This procedure has a comparable safety profile to similar ESD procedures used to treat other conditions.

Keywords: Barrett's esophagus; adenocarcinoma; cohort study; endoscopic submucosal dissection; esophageal squamous cell carcinoma.

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Conflict of interest statement

None.

Figures

FIGURE 1
FIGURE 1
Flow chart of the processes for patient enrolment and analysis of the lesions.
FIGURE 2
FIGURE 2
Lesion location, depth of invasion, and microscopic type. SMM, superficial muscularis mucosa; LPM, lamina propria mucosa; DMM, deep muscularis mucosa; SM1, inner third invasion of the submucosa; SM2, middle third invasion of the submucosa.
FIGURE 3
FIGURE 3
Proportion of BEA cases among the total esophageal ESD cases. BEA, Barrett's esophageal adenocarcinoma; ESSC, esophageal squamous cell carcinoma; ESD, endoscopic submucosal dissection.
See this image and copyright information in PMC

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