| Theme | Expansion of Indications for Endoscopic Mucosal Resection of Early Gastrointinal Cancer | |
|---|---|---|
| Title | Endoscopic Mucosal Resection for Treatment of Superficial Esophageal Cancer -- Recent Clinical Results and Extended Indications | |
| Publish Date | 2001/11 | |
| Author | Kumiko Momma | Department of Endoscopy, Tokyo Metropolitan Komagome Hospital |
| Author | Misao Yoshida | Department of Surgery, Tokyo Metropolitan Komagome Hospital |
| Author | Yoshiya Yamada | Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital |
| Author | Kozue Amemiya | Department of Endoscopy, Tokyo Metropolitan Komagome Hospital |
| Author | Takeo Arakawa | Department of Endoscopy, Tokyo Metropolitan Komagome Hospital |
| Author | Hiroshi Kozawa | Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital |
| Author | Hisahito Kato | Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital |
| Author | Nobuhiro Sakaki | Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital |
| Author | Yosuke Izumi | Department of Surgery, Tokyo Metropolitan Komagome Hospital |
| Author | Tomoko Hanashi | Department of Surgery, Tokyo Metropolitan Komagome Hospital |
| Author | Kenichi Ohashi | Department of Pathology, Tokyo Metropolitan Komagome Hospital |
| Author | Nobuaki Funata | Department of Pathology, Tokyo Metropolitan Komagome Hospital |
| [ Summary ] | Endoscopic mucosal resection (EMR) is indicated for esophageal cancer confined to the lamina propria mucosae (m1 andm2). This may cause mucosal defectless than 3/4 the circumference after EMR. Good clinical results may be expected for lymph node metastasis, esophageal strictures being rare. The incidence of local recurrence was 8.3% out of 155 patients who underwent EMR. Local recurrence was identified 3 to 40 months after EMR. Ten cases out of 13 patients with local recurrence were treated with EMR. Pathological studies on resected specimens revealed that all cancers were confined to the mucosa. Metachronous multiple esophageal cancer was detected in 12.4% of all patients with EMR. They had been detected 6 to 113 months after EMR. 92.5% of all metachronous esophageal cancers underwent a second EMR. Pathological diagnosis of them showed that cancers remained within the mucosa. EMR allows us to remove esophageal cancers with infiltration of the muscularis mucosae (m3) a slight invasion into the submucosa (sm1) while there is lymph node metastasis in about 10% of all cases. The clinical differentiation between m3 and sm1 with lymph node metastases is required before we apply EMR to these cases. | |