A Clinicopathological Study of Multiple Superficial Carcinoma of the Esophagus

Akira Kanamoto, Hajime Yamaguchi, Hitoshi Kondo, Takuji Gotoda, Hiroyuki Ono, Yuji Tachimori¹⁾, Hoichi Kato¹⁾, Hiroshi Watanabe¹⁾, Yukihiro Nakanishi²⁾

Department of Internal Medicine, National Cancer Center Hospital
¹⁾Department of Surgery, National Cancer Center Hospital
²⁾Pathology Division, National Cancer Center Hospital

A retrospective evaluation of 334 patients with superficial squamous cell carcinoma of the esophagus, who underwent esophagectomy or endoscopic mucosal resection without pre-operative treatment from 1962 to June 1997, revealed 94 cases (28.1%) of multiple superficial carcinoma of the esophagus. The male-to-female ratio within this group was 93:1, versus 5:1 for single superficial carcinoma of the esophagus (p< 0.0001). The Brinkman index was significantly higher in patients with multiple carcinoma than in those with single carcinoma (p<0.05). The incidence of pharyngeal malignancy was also significantly higher in the patients with multiple carcinomas (p<0.001). There was no significant difference between those groups with regard to extent of lymph node metastasis or prognosis. We evaluated the characteristics of 140 secondary lesions in 94 patients with multiple carcinoma, with the following results: 1) 74.5% of the patients with multiple primary tumors had only one second lesion. 2) Endoscopic type 0-IIc or 0-IIb lesions were found in 90%. 3) Mucosal cancer was found in 90%. 4) The maximum length of a lesion was less than 1 cm in 65%. 5) The distance between the main tumor and the second lesion was less than 3 cm in 67%. It is important to keep multiple tumors and multifocal tumors in mind for diagnosis, treatment and follow-up of superficial carcinoma of the esophagus.

Key words
carcinoma of the esophagus, superficial carcinoma of the esophagus, multiple superficial carcinoma of the esophagus, squamous cell carcinoma of the esophagus

Reprint requests
Akira Kanamoto Department of Gastroenterological Surgery, Mitsui Memorial Hospital
1 Kandaizumichyo, Chiyoda, Tokyo, 101-0024, JAPAN

Accepted
April 22, 1998

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