Two cases of superficial esophageal cancer recurred after Argon Plasma Coagulation

Abstract

Since January 2001, the patients with a superficial esophageal cancer who could not undergo the endoscopic mucosal resection (EMR) have been treated by Argon Plasma Coagulation (APC) in our institute. A recurrence after the APC was observed in two cases.
Case 1 : A 65-year-old man. He was pointed out to have a 0-IIc type of esophageal cancer at the middle thoracic esophagus in 2000. Firstly, radiation was selected because he had liver cirrhosis with esophageal varices. A recurrence was observed after the radiation, APC was performed in August 2001. In January 2002, APC was repeated because the recurrence after the ablation was observed.
Case 2 : A 69-year-old man．Endoscopic examination revealed a 0-IIb type of esophageal cancer at the middle thoracic esophagus. EMR was avoided because of his bleeding tendency due to the medication for cerebral infarction and angina pectoris, then instead, APC was performed in January 2002. But the recurrence was observed about 6 months after the ablation and he underwent APC again.
Because the depth of esophageal tissue degeneration by APC is thought to be limited to the submucosal layer, it is enough for superficial cancer of esophagus to be treated. EMR is thought to be the first primary method. However, APC may be useful in cases patients have complication which make EMR difficult.