|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
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.
DiscussionBecause staging techniques are inaccurate, the differences between the early stages of esophageal cancer remain unclear. Therefore, endoscopic treatment for clinically staged early esophageal cancer should be used with caution. For patients with submocosal extension, esophagectomy is preferred because of the relatively high incidence of lymph node metastasis.