A Clinicopathologic Study of Esophageal Carcinoma with Intramural Metastasis to the Stomach

Masayuki Shinoda, Iwao Takagi, Motokazu Suyama, Naoki Kuroda, Kazuo Kunishimia, Kazuo Karasawa, Haruo Aoki*

Department of Thoracic Surgery, Aichi Cancer Center Hospital
*Department of Gastroenterological Surgery, Fujita Health University

Ten cases of esophageal carcinoma with intramural metastasis to the stomach were clinicopathologically studied, and their outcome was compared with that of cases with intramural metastasis limited to the esophagus. The incidence was 4.7% of the 217 patients receiving resections in Aichi Cancer Center Hospital from January 1983 to June 1991. One tumor was located in the upper,6 in the middle and 3 in the lower intra-thoracic esophagus. Histologic types were diagnosed as well-differentiated squamous cell carcinoma (SCC) in one case, moderately differentiated SCC in 6 and poorly differentiated SCC in 3. In the histologic examination for depth of invasion, 5 cases showed invasion into the adventitia and the other 5 cases into the adjacent structures beyond the adventitia. Lymph node metastasis to group 3 or beyond was present in 9 cases. Consequently, the pathologic stages of the 10 cases were classified as IV according to the Guide Lines for the Clinical and Pathologic Studies on Carcinoma of the Esophagus in Japan. The 1-year survival rate of the patients with intramural metastasis to the stomach was 25.0% and all patients died within 2 years. On the other hand, the l-year and 5-year survival rates of the patients with intramural metastasis within the esophagus were 60.6% and 23.3%, respectively. Various opinions on the staging of cases with stomach metastasis appear in the literature. Our study seems to justify classification of those cases as stage IV because of their poor outcome, which was very similar to that in other stage IV cases with invasion into the neighboring organs.

Key words
esophageal cancer, intramural metastasis to the stomach

Reprint requests
Masayuki Shinoda Department of Thoracic Surgery, Aichi Cancer Center Hospital
1-1 Kanokoden, Chikusa-ku, Nagoya, 464 JAPAN

Accepted
March 11, 1992

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