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Expansion of the indications for endoscopic mucosal resection in patients with superficial esophageal carcinoma.
Endoscopy. 2007 Jan; 39(1):36-40.E

Abstract

BACKGROUND AND STUDY AIMS

Endoscopic mucosal resection (EMR) is a minimally invasive local treatment for superficial esophageal carcinoma (SEC). The use of EMR in patients with m3 or sm1 SEC remains controversial, however. The aim of this retrospective study was to evaluate the histopathological risk factors for lymph-node metastasis and recurrence in patients with m3 or sm1 SEC.

PATIENTS AND METHODS

The study subjects were 43 patients with m3 or sm1 esophageal squamous-cell carcinomas: 23 patients were treated surgically (the surgery group), and 20 were treated by EMR (the EMR group). We assessed the following variables of the specimens resected by surgery or EMR: tumor depth, maximal surface diameter of the tumor (superficial size), maximum diameter of tumor invasion at the lamina muscularis mucosae (LMM invasion width), and lymphatic invasion. The relationships of these variables to lymph-node metastasis and recurrence were examined.

RESULTS

In the surgery group, lymph-node metastasis was found in four patients, all of whom had tumors with lymphatic invasion, a superficial size of at least 25 mm, and an LMM invasion width of at least 2500 microm. In the EMR group, no patient met all three of these criteria, and there was no evidence of lymph-node metastasis or distant metastasis on follow-up after EMR (median follow-up 39 months).

CONCLUSIONS

In patients with m3 or sm1 SEC, tumors that have lymphatic invasion, larger superficial size, and wider LMM invasion are associated with a high risk for lymph-node metastasis. EMR might be indicated for the treatment of patients with m3 or sm1 SECs without these characteristics.

Authors+Show Affiliations

Department of Gastroenterology, Kitasato University East Hospital, Sagamihara, Japan. k.higu@kitasato-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17252458

Citation

Higuchi, K, et al. "Expansion of the Indications for Endoscopic Mucosal Resection in Patients With Superficial Esophageal Carcinoma." Endoscopy, vol. 39, no. 1, 2007, pp. 36-40.
Higuchi K, Tanabe S, Koizumi W, et al. Expansion of the indications for endoscopic mucosal resection in patients with superficial esophageal carcinoma. Endoscopy. 2007;39(1):36-40.
Higuchi, K., Tanabe, S., Koizumi, W., Sasaki, T., Nakatani, K., Saigenji, K., Kobayashi, N., & Mitomi, H. (2007). Expansion of the indications for endoscopic mucosal resection in patients with superficial esophageal carcinoma. Endoscopy, 39(1), 36-40.
Higuchi K, et al. Expansion of the Indications for Endoscopic Mucosal Resection in Patients With Superficial Esophageal Carcinoma. Endoscopy. 2007;39(1):36-40. PubMed PMID: 17252458.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Expansion of the indications for endoscopic mucosal resection in patients with superficial esophageal carcinoma. AU - Higuchi,K, AU - Tanabe,S, AU - Koizumi,W, AU - Sasaki,T, AU - Nakatani,K, AU - Saigenji,K, AU - Kobayashi,N, AU - Mitomi,H, PY - 2007/1/26/pubmed PY - 2007/3/10/medline PY - 2007/1/26/entrez SP - 36 EP - 40 JF - Endoscopy JO - Endoscopy VL - 39 IS - 1 N2 - BACKGROUND AND STUDY AIMS: Endoscopic mucosal resection (EMR) is a minimally invasive local treatment for superficial esophageal carcinoma (SEC). The use of EMR in patients with m3 or sm1 SEC remains controversial, however. The aim of this retrospective study was to evaluate the histopathological risk factors for lymph-node metastasis and recurrence in patients with m3 or sm1 SEC. PATIENTS AND METHODS: The study subjects were 43 patients with m3 or sm1 esophageal squamous-cell carcinomas: 23 patients were treated surgically (the surgery group), and 20 were treated by EMR (the EMR group). We assessed the following variables of the specimens resected by surgery or EMR: tumor depth, maximal surface diameter of the tumor (superficial size), maximum diameter of tumor invasion at the lamina muscularis mucosae (LMM invasion width), and lymphatic invasion. The relationships of these variables to lymph-node metastasis and recurrence were examined. RESULTS: In the surgery group, lymph-node metastasis was found in four patients, all of whom had tumors with lymphatic invasion, a superficial size of at least 25 mm, and an LMM invasion width of at least 2500 microm. In the EMR group, no patient met all three of these criteria, and there was no evidence of lymph-node metastasis or distant metastasis on follow-up after EMR (median follow-up 39 months). CONCLUSIONS: In patients with m3 or sm1 SEC, tumors that have lymphatic invasion, larger superficial size, and wider LMM invasion are associated with a high risk for lymph-node metastasis. EMR might be indicated for the treatment of patients with m3 or sm1 SECs without these characteristics. SN - 0013-726X UR - https://www.unboundmedicine.com/medline/citation/17252458/Expansion_of_the_indications_for_endoscopic_mucosal_resection_in_patients_with_superficial_esophageal_carcinoma_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2006-945148 DB - PRIME DP - Unbound Medicine ER -