Possibility of Endoscopic Mucosal Resection in Patients with m3 and sm1 Esophageal Cancer Hiroyasu Makuuchi 1 1Department of Surgery, Tokai University, School of Medicine Keyword: 食道表在癌 , 内視鏡的粘膜切除術 , m3・sm1食道癌 , 食道癌切除術 , リンパ節転移 pp.993-1002
Published Date 1998/6/25
DOI https://doi.org/10.11477/mf.1403103746
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 Patients with m3・sm1 esophageal cancer have lymph node metastasis at the rate of 10~15%. However, more than 85% of the patients have no lymph node metastasis. For these patients endoscopic mucosal resection (EMR) is indicated as the most suitable treatment. Of 101 cases of m3・sm1 esophageal cancers treated in our institution,EMR was indicated as the treatment of choice in 55 cases (54.5%). Because of the high rate of lymph node metastasis EMR should be avoided in the following cases: (1) 0-Ⅱc + Ⅱa type,0-Ⅲ type, and 0-Ⅰ type. (2) Lesions of which the diameter is more than 5 cm, or which occupy the whole circumference of the esophageal lumen. Among these patients,31.7% of (1) and (2) cases had lymph node involvement, and 72.7% of the m3・sm1 cases with lymph node metastasis were involved in this group. In cases other than these,EMR is indicated as a first step, but after pathological examination of resected specimens is performed, those patients with (1) lymph vessels invasion〔ly(+)〕, and (2) infγ,(3) poorly differentiated squamous carcinomas, should recieve radical surgical treatment continuously. On our study,49.5% of all m3・sm1 esophageal cancer cases were treated with EMR and the remaining 50.5% of the patients were treated with radical surgical treatment.

 As for the patients with lymph node metastasis radical surgery is indicated in 100% of the cases.

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