| Theme | Current Topics on The Treatment for Esophageal Cancer | |
|---|---|---|
| Title | Endoscopic Mucosal Resection for m3•sm1 Esophageal Cancer | |
| Publish Date | 2003/10 | |
| Author | Hiroyasu Makuuchi | Department of Digestive Surgery, Tokai University, School of Medicine |
| Author | Hideo Shimada | Department of Digestive Surgery, Tokai University, School of Medicine |
| Author | Osamu Chino | Department of Digestive Surgery, Tokai University, School of Medicine |
| Author | Hikaru Tanaka | Department of Digestive Surgery, Tokai University, School of Medicine |
| Author | Tkayuki Nishi | Department of Digestive Surgery, Tokai University, School of Medicine |
| Author | Takashi Kise | Department of Digestive Surgery, Tokai University, School of Medicine |
| [ Summary ] | Superficial esophageal cancer, of which depth of invasion is limited to the muscularis mucosa (m3) or shallow layer of the sub mucosa (sm1) has lymph node metastasis rate of only 15%. For this reason we should extend the indications for EMR to these cases. In cases of m3, sm1 esophageal cancer, radical surgical treatment is indicated for those where clinical classifications are of the 0-I or 0-III type, the 0-IIc+0-IIa or the 0-IIa+0-IIc type, and where the diameter is over 4cm. Lymph node metastasis should be included, due to an involvement rate of 33.3%. Endoscopic mucosal resection is indicated for m3, sm1 cancer cases where technically possible. Patients with ly (+), infγ or poorly differentiated types should be receive radical surgery. Seventy nine cases of m3, sm1 cancer, which received EMR, had lymph node recurrence rates of 4.1% and distant organ recurrence rates of 2.7%. The five year survival rate was 88.0%. As we can determine from this information, accurate preoperative diagnoses of lymph node metastasis is essential. |
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