[An autopsy study of the mode of cancer metastasis on the esophagectomied patients for esophageal cancer].
The records of autopsy on 43 patients underwent esophagectomy were evaluated retrospectively. Fifteen patients were performed palliative surgical treatment and 28 were curative, there were 41 men and 2 women in the series. The mean age at the first operation was 59.5 yr. The distribution of the primary lesions were 1 cervical, 40 thoracic (3 upper intra-thoracic, 28 middle intra-thoracic and 9 lower intra-thoracic) and 2 abdominal esophagus. There were 42 cases of squamous cell carcinoma (13 well differentiated types, 25 moderately differentiated types and 4 poorly differentiated types) and 1 adenosquamous cell carcinoma. Their stage classification were 0 for 2 patients, I for 1, III for 13 and IV for 27. In cases of palliative surgical treatment, the residual tumor were present on 6 cases in trachea or bronchus and 2 in aorta. Others were the rest of metastatic nodes in 3 cases, positive surgical margin in 3 and visceral metastasis and peritoneal dissemination in 1. At autopsy, 14 patients (93%) had distant organ metastases, 11 (73%) local recurrent tumor, 11 (73%) node metastases and 9 (60%) disseminations. In cases of curative surgical treatment, the first recurrent sites were as follows. Lymph node metastasis observed in 20 cases (71%), local recurrence in 9 cases (32%), distant organ metastases in 8 cases (28%) and disseminations in 5 cases (18%). While at autopsy, 24 patients (86%) had lymph node metastases, 20 (71%) distant organ metastases, 15 (54%) local recurrent tumors and 11 (39%) disseminations. On 10 cases whose first recurrent site was observed only at lymph node, 9 cases (90%) had distant organ metastases at autopsy. In both cases of palliative surgical treatment and of curative surgical treatment, the most dominant metastatic site at autopsy was distant organ metastasis. Therefore, in the future, distant organ metastasis must be an important target for esophageal cancer treatment.
Tenma
K
K
Second Department of Surgery, Akita University School of Medicine, Japan.
Abo
S
S
Kitamura
M
M
Hashimoto
M
M
Izumi
K
K
Shikama
T
T
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local