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The Clinicopathological Characteristics and Prevalence of Superficial Esophagogastric Junctional Adenocarcinomas with Lymph Node Metastases Hiroaki Takahashi 1 , Ryu Ishihara 2 , Junichi Kodaira 1 , Rinako Himori 1 , Yasuhiro Tachibana 1 , Hirokazu Oohashi 1 , Satoshi Okahara 1 , Miwako Kudaira 1 , Nobuaki Sugawara 1 , Takeshi Matsumoto 1 , Tomoyuki Oouchi 3 , Toshinao Takenouchi 3 , Masao Hosokawa 4 , Tsuneo Oyama 5 1Department of Gastroenterology, Keiyukai Daini Hospital, Sapporo, Japan 2Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan 3Department of Pathology, Keiyukai Sapporo Hospital, Sapporo, Japan 4Department of Surgery, Keiyukai Sapporo Hospital, Sapporo, Japan 5Department of Endoscopy, Saku Central Hospital Advanced Care Center, Saku, Japan Keyword: 食道胃接合部腺癌 , 転移 , リスク因子 , SM1 , 内視鏡的切除 pp.319-328
Published Date 2017/3/25
DOI https://doi.org/10.11477/mf.1403200854
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 The criteria of curative endoscopic resection have not been well-established yet because little is known about the characteristics and prevalence of lymph node metastases in superficial esophagogastic junctional adenocarcinomas, especially, the discussion of whether SM1 invasion should be defined by the criteria of esophageal cancer or gastric cancer. Accordingly, we conducted a multicenter retrospective study in order to elucidate the risks of metastasis in adenocarcinoma of the esophagus, and patients with esophagogastric junctional adenocarcinomas were selected in this study. Among 385 patients who were subjected to surgery or endoscopic resection for mucosal or submucosal adenocarcinoma of the esophagogastric junction, 54 patients were diagnosed with metastatic cancer. With regards to the invasion depth, metastasis was observed in 6.9%(6 out of 87)of the patients with the cancer invading into the deeper muscularis mucosa and in 3.9%(2 out of 51)of the patients with SM cancers invading less than 500μm from the muscularis mucosa. In the latter cases, no metastasis was observed in the patients without factors such as lymphovascular involvement, poorly differentiated component, and lesion size <30mm in diameter. Thus, we conclude that the depth of SM1 invasion should be defined as less than 500μm from the muscularis mucosa.


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

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