Endoscopic Diagnosis of Tumor Invasion of Superficial Esophageal Carcinoma and the Indication of Endoscopic Mucosectomy as a Curative Treatment

Masayuki Kurooka, Hajime Yamaguchi*, Masayuki Itabashi**, Hiroki Tamura, Yuji Tachimori, Hoichi Kato, Hiroshi Watanabe

Department of Surgery, Department of Medical Oncology*, Pathology Division**, National Cancer Center Hospital and Research Institute

We examined endoscopic and pathological findings of superficial esophageal carcinomas and tried to determine indications for curative endoscopic mucosectomy. We examined 57 lesions of 0-IIc type and 0 IIb type (slightly depressed type and superficial flat type) superficial esophageal carcinomas in 53 patients who underwent surgery or endoscopic mucosectomy in the National Cancer Center Hospital, Tokyo. We classified them into seven groups as ep, mm1, mm2, mm3, sm1, sm2 or sm3 according to the depth of tumor invasion. In the pathological study, ep and mm1 carcinomas had no vessel invasion or lymph node metastasis, and could thus be cured with endoscopic mucosectomy. We tried to diagnose them by endoscopic findings, and these findings were confirmed by pathological study of the resected specimen. In the endoscopic study, ep and mm1 carcinomas could be defined as lesions which have all the following findings. 1) without deep depression, 2) without large granule or nodule on the surface, 3) without mucosal thickening around the depression, 4) without stiffiness. The rate of accuracy of diagnosis was 92.3%. Thus ep and mm1 carcinomas were suitable for curative endoscopic mucosectomy and we could diagnose them accurately from endoscopic findings.

Key words
superficial esophageal carcinoma, endoscopic mucosectomy, subclassification for the depth of tumor invasion

Reprint requests
Masayuki Kurooka Department of Radiation Biology, Faculty of Medicine, Osaka University
2-2 Yamadaoka, Suita-city, 565 JAPAN

Accepted
May 17, 1995

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