Pathology of Early Invasive Adenocarcinoma of the Esophagus or Esophagogastric Junction -- Implications for Therapeutic Decision Making
Johanna W. van Sandick, J. Jan B. van Lanschot, Fiebo J. W. ten Kate, et al.
Abramson Cancer Center of the University of Pennsylvania
Last Modified: November 1, 2001
Reviewers: Li Liu, MD
Source: Cancer, Volume 88:2429-2437, (June) 2000
Précis: Esophagectomy remains the preferred treatment for early esophageal cancer
IntroductionThe treatment of esophageal cancer remains a challenge. Controversy persists regarding the optimal surgical approach to this disease. Tumors confined to the mucosa and submucosa, without metastases to the regional lymph nodes, both esophagectomy and endoscopic ablation are used for cure. In this report, the researchers evaluated the pathologic features of early adenocarcinoma of esophagus in an attempt to rationalize therapeutic decision making.
MethodPathology reports and slides of 173 patients who had esophagectomies for invasive adenocarcinoma were reviewed.
- 19% of patients had early stage cancer.
- 7% of patients had tumor invasion limited to the mucosa. Of them, no lymph node metastases were found.
- 12% had tumor that invaded the submucosa. Lymph node metastases were present in 30% of them.
- Intestinal metaplasia was present in all the cases.
- The 3-year cause-specific survival for patients with intramucosal cancer was 100% and survival was 82% for patients with submucosa cancer.