Pathology of Early Invasive Adenocarcinoma of the Esophagus or Esophagogastric Junction Implications for Therapeutic Decision Making

摘要: BACKGROUND. As an alternative to surgical resection, endoscopic treatment modalities are being explored for the of patients with early esophageal carcinoma. This study aimed evaluate patterns local growth and regional dissemination adenocarcinoma esophagus or esophagogastric junction, as these pathologic features may contribute rational therapeutic decision making. METHODS. Among 173 who underwent resection invasive (1993‐1998), 32 (19%) had stage cancer (pT1). Clinical records, pathology reports, original slides surgically resected were reviewed in each case. RESULTS. In 12 tumor invasion was limited mucosa, whereas 20 showed infiltration submucosa. All cancers associated intestinal metaplasia. Areas high grade dysplasia accompanied 27 (84%). Intramucosal no lymph node metastasis but presented multifocal disease 42% cases extended under preexisting squamous mucosa 17% cases. submucosal cancer, metastases present 30% Disease specific 3-year survival intramucosal 100% those 82% (P 5 not significant). CONCLUSIONS. Based on pattern this should be applied caution. For carcinoma, surgery is mainstay treatment, frequently present. Both subclassifications show a favorable outcome after esophagectomy. Cancer 2000;88:2429 ‐37. © 2000 American Society.