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Japanese

Optimum Treatment for m3・sm1 Esophageal Cancer: The Surgeons' Point of View Hiromasa Fujita 1 , Susumu Sueyoshi 1 , Hideaki Yamana 1 , Kazuo Shirouzu 1 , Hiroshi Harada 2 1Department of Surgery, Kurume University School of Medicine 2The Second Department of Internal Medicine, Kurume University School of Medicine Keyword: 食道表在癌 , 食道切除術 , 内視鏡的粘膜切除術 , リンパ節転移 , 脈管侵襲 pp.1003-1010
Published Date 1998/6/25
DOI https://doi.org/10.11477/mf.1403103747
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 The purpose of this study was to determine the optimum treatment strategy for a superficial esophageal cancer involving the muscularis mucosa (m3) or the shallower third of the submucosal layer (sm1) of the esophagus. The histological findings from the resected specimens, the incidences of lymph node metastasis and recurrence, and the survival rates were retrospectively analysed in 42 cases with an m3 or sm1 cancer that underwent esophagectomy, endoscopic mucosal resection (EMR), or radiotherapy, in Kurume University Hospital, during the period from 1981 to 1997. No local recurrence was observed after EMR or radiotherapy for cases with an m3 or sm1 cancer. Lymph node metastasis and/or recurrence and lymphatic and/or vascular invasion were rarely observed in cases of an m3 cancer, while these were frequently observed in cases of an sm1 cancer. We consider that patients at a high risk to lymph node metastasis should undergo esophagectomy with lymphadenectomy, because preoperative staging of lymph node metastasis has remained incomplete even using the most modern investigative methods. Following an EMR for a superficial esophageal cancer, the depth of invasion, and lymphatic and/or vascular invasion must be confirmed by histological examination of the endoscopically resected specimen. While EMR alone or EMR with the addition of radiotherapy can be sufficient for curative treatment for an m3 cancer without lymphatic and/or vascular invasion, esophagectomy with lymphadenectomy is recommended as the treatment of first choice for an m3 cancer with lymphatic and/or vascular invasion and for an sm1 cancers.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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