Pathologic features of superficial esophageal squamous cell carcinoma with lymph node and distal metastasis.
BACKGROUND
Endoscopic mucosal resection (EMR) is a less invasive localized treatment for patients with esophageal carcinoma. However, indications for EMR use in cases of superficial esophageal carcinoma are controversial. The authors evaluated histopathologic risk factors for lymph node metastasis and recurrence.


METHODS
In the specimens resected, the authors examined depth, the superficial area and the area attached to or infiltrating the lamina muscularis mucosa.


RESULTS
The authors found that the superficial area and the attached or infiltrated area reflected the depth of the tumor. However, there was a recurrence of esophageal carcinoma even in m3 cases attached only to the lamina muscularis mucosa.


CONCLUSIONS
The authors concluded that ml and m2 esophageal carcinoma had almost no risk of lymph node metastasis and recurrence no matter how extensive the superficial area. In addition, sm2 and sm3 carcinoma have a high frequency of lymph node metastasis and recurrence. M3 and sm1 carcinoma run the risk of lymph node metastasis and recurrence however small the superficial area and the area attached to or infiltrating the lamina muscularis mucosa. Treatment strategies for patients with superficial esophageal carcinoma, including EMR, should take the above findings into account.
Araki
Koshi
K
Department of Surgery and Science, Faculty of Medicine, Kyushu University, Fukuoka, Japan. ayushi@mint.ocn.ne.jp
Ohno
Shinji
S
Egashira
Akinori
A
Saeki
Hiroshi
H
Kawaguchi
Hidetoshi
H
Sugimachi
Keizo
K
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000556:secondary* / Q000601:surgery; D004938:Esophageal Neoplasms / Q000145:classification / Q000473:pathology* / Q000601:surgery; D004947:Esophagus / Q000098:blood supply / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology / Q000601:surgery; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D009383:Neoplasms, Vascular Tissue / Q000473:pathology; D011379:Prognosis