Different Managements for Esophageal Epithelial Neoplasms between the Japanese, Singaporean, and Korean Endoscopists

ABSTRACT

BACKGROUND/AIMS: There are controversies for the management of esophageal neoplasia due to its variety among countries. In this study, we tried to uncover the different managements on esophageal neoplasia between Korea, Singapore, and Japan. MATERIALS AND METHODS: We administered ten questionnaires to Korean, Japanese, and Singaporean endoscopists. The questionnaire consisted of endoscopic images from ten different esophageal neoplasms. RESULTS: For Barrett esophagus (BE) with adenocarcinoma (P=0.013) and well-differentiated- type squamous cell carcinoma (P=0.007), all (100%) of the Japanese endoscopists selected endoscopic resection as treatment, whereas 25~40% of the Korean and Singaporean endoscopists selected surgical resection. For BE with low grade dysplasia (P=0.002) and flat-type squamous dysplasia (P<0.001), observation without endoscopic treatment was preferred in Japan, whereas endoscopic treatment was preferred in Korea and Singapore. Similar findings between three countries were; (i) medication for BE, (ii) endoscopic treatment for BE with high grade dysplasia and elevated-type squamous dysplasia, and (iii) operation for moderately-differentiated or poorly-differentiated typed SCC. CONCLUSIONS: Our survey addresses different managements on esophageal neoplasia between Korea, Singapore, and Japan. More advanced or aggressive treatments are preferred in Korea and Singapore than in Japan for the management of BE with LGD, flat-type squamous dysplasia, BE with adenocarcinoma, and WD-typed SCC.