Management of the Superficial Esophageal Cancer of the Thoracic Esophagus as Related to Clinico-pathological Factors and Prognosis

Junzo Sayama, Koh Sugawara, Ryuzaburo Shineha, Katsu Hirayama, Tetsuro Nishihira, Shozo Mori

Second Department of Surgery, Tohoku University School of Medicine

Management of superficial esophageal cancer was assessed by investigating clinico-pathological factors and the prognosis of 88 patients (ep 14, mm 12, sm 61). The five-year survival rate of the 14 patients with ep cancer was 100% in the absence of lymph node metastasis, vascular invasion and cancer recurrence. The five-year survival rate of the 13 patients with mm cancer was good at 83.3%. However, three patients with mm₃ cancer experiencd lymph node metastasis and two of them suffered from postoperative cancer recurrence. The five-year survival rate (64.5%) of the 61 patients with sm cancer tended to be related to the degree of invasion to the submucosal layer and vascular invasion, although there was no difference in the prognosis of patients with sm cancer with regard to lymph node metastasis. Patients treated by T-shaped irradiation combined with chemotherapy or by aggressive chemotherapy tended to have better survival rates than those who received no adjuvant therapy or only T-shaped irradiation. Eight of the patients with sm cancer experienced postoperative cancer recurrence, and in five of the patients with sm_2.3 cancer located at Im, recurrence was recognized in cervical lymph nodes. Therefore, blunt dissection is efficactious in the patients with ep and mm_1.2 cancer, but mm₃ and sm cancers should be treated with lymph node dissection and sufficient postoperative adjuvant therapies. Particularly in cases of sm_2.3 cancers located at Iu or Im, cervical lymph node dissection is suggested.

Key words
superficial esophageal cancer, esophageal mucosal cancer, surgery for superficial esophageal cancer, postoperative adjuvant therapies for superficial esophageal cancer

Reprint requests
Junzo Sayama Second Department of Surgery, Tohoku University School of Medicine
1-1 Seiryo-machi, Aoba-ku, Sendai, 980 JAPAN

Accepted
February 9, 1994

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