[Diagnosis and surgical treatment of early esophageal cancer].
144 cases of the superficial esophageal cancer, of which invasion was limited to the submucosa, have been resected for the last 23 years. 94 cases (65%) were early cancer, and 50 cases (35%) were superficial cancer with metastasis. The 5-year survival rate of early cancer cases was 65%, otherwise, that of superficial cancer cases with metastasis was 24%. There was a significant difference between these two groups. As for the depth of cancerous invasion, the 5-year survival rate of mucosal cancer cases was 100%. That of submucosal cancer cases was 70% even in cases without nodal involvement. Analyzing the cancerous depth of the superficial cancer and its nodal involvement and its vascular invasion, the lymph node metastasis and the vascular invasion were not observed in 90% of mucosal cancer cases, otherwise these were negative only in 30% of submucosal cancer cases. So to obtain the remarkable improvement of the long term results of esophageal cancer, the diagnosis and the treatment of mucosal cancer of the esophagus are essential. The endoscopic examination have come to play a large role for the diagnosis of mucosal cancer of the esophagus. Moreover, the endoscopic dyeing with Lugol's solution is important in the diagnosis of flat type of esophageal lesions, that is mucosal cancer and epithelial cancer. At present time, the treatment of early esophageal cancer is in principle surgery. And the operative mortality was low, 1.4%. However, the non-invasive treatments; endoscopic LASER therapy, radiation, endoscopic strip-biopsy etc., will be performed more frequently in minute mucosal cancer.
Endo
M
M
Yoshino
K
K
Takeshita
K
K
Takiguchi
T
T
Kouno
T
T
Yamazaki
S
S
D000368:Aged; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography