Clinical Study on Esophageal Carcinoma with Intramural Metastasis to the Stomach -Case Reports-

Reijiro Saito, Shichisaburo Abo, Michihiko Kitamura, Masaji Hashimoto, Keiichi Izumi, Toshio Shikama, Kazuo Tenma, Shuichi Kamata, Yoshihiro Minamiya

The Second Department of Surgery, Akita University School of Medicine

We conducted a clinicopathological study on the incidence of esophageal carcinoma with intramural metastasis to the stomach and its relationship to prognosis and survival. The data on 384 patients with esophageal carcinoma who underwent esophagectomy in our department from January 1981 through August 1994 were reviewed. In (1.6%) patients, intramural metastasis to the stomach was observed, and the histologic type was squamous cell carcinoma in all cases. Lymphatic invasion and lymph node metastasis were observed in all cases and the histological stage was III in one case and IV in 5 cases. The mean size of the metastatic lesions was 3.1 cm, though giant protruding tumors (7 and 6 cm in diameter) were observed in 2 cases. The outcome was very poor, with all except one of the patients dying. The mean survival time was 8.3 months (range 2-17). The two patients with giant metastatic tumors died within 5 months. Not only lymph node metastasis but also distant organ metastasis (liver in 3 cases, bone in 1 case) were observed as the site of recurrence. These data indicate that an extended operation and postoperative chemotherapy are necessary to improve the outcome for patients with intramural metastasis to the stomach. However, if the metasatic tumor is larger than 6 cm in diameter, preoperative chemotherapy must be combined with surgery because of the systemic spread of the carcinoma.

Key words
esophageal carcinoma, intrarmural metastasis to the stomach

Reprint requests
Reijiro Saito The Second Department of Surgery, School of Medicine, Akita University
1-1-1 Hondo, Akita, 010 JAPAN

Accepted
October 11, 1995

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