Evidence-Based Practice in A Patient with Superficial Esophageal Cancer
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Abstract
Objective To formulate an evidence-based practice for the patient with superficial esophageal cancer. Methods After some clinical problems about the diagnosis and treatment of superficial esophageal cancer being proposed, the latest clinical guidelines were found on the websites (www.guideline.org, www.nccn.org), and the Ovid databases(ALL EBM reviews,MEDLINE)(1950 to Feb 2011), Web of Knowledge(1900 to Feb 2011), PubMed (1970 to Feb 2011) and CNKI(1976 to Feb 2011)were searched to collect the relevant evidences. The validity, reliability and feasibility of each study were evaluated to select the current best evidences. Results A total of 24 documents were qualified, including 2 systematic reviews (SRs), 2 meta-analyses, 2 guidelines and 1 randomized controlled trial (RCT). According to the current evidences and the patient’s preference, the diagnosis of esophageal cancer was established by flexible endoscopy and biopsy, and endoscopic submucosal dissection (ESD) technique was safe and effective for this patient.Whereas chemoradiotherapy was not suitable for him. The patient’s symptoms were relieved after two weeks of treatment. Two years of follow-up indicated the practice was suitable for this patient. Conclusions Multiple diagnostic methods should be applied to identify the early stage of esophageal cancer. The current evidences suggest that endoscopic surveillance following ESD therapy is an effective strategy to treat this kind of patients.
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