Prognostic Impact of Upper, Middle, and Lower Third Mucosal or Submucosal Infiltration in Early Esophageal Cancer

Abstract

After esophagectomy, the prognosis of patients with sm1/sm2 infiltration is as good as for patients with mucosal carcinoma. Sm3 infiltration is the worst prognostic factor in pT1 esophageal cancer.

The frequency of lymph node metastasis in early-stage adenocarcinoma of the esophagus with incipient submucosal invasion (pT1b sm1) depending on histological risk patterns

“…In case of only incipient submucosal invasion (pT1b sm1), the risk of LN metastasis ranges from 0 to 20 % [21][22][23][24][26][27][28][29][30][31]. Moreover, two retrospective surgical series suggested that among the sm1 EAC lesions, there might be a favorable histological pattern going along with a very low risk of LN metastasis [21,22], in accordance with rates known from pT1a EAC [19,[21][22][23][24].…”

“…Patients with ulcerated neoplasia are, in general, not eligible for an ET approach. It is important to point out that the macroscopic tumor type, including ulcerated lesions, may be difficult to assess during a retrospective surgical study [27][28][29][30][31].…”

“…Data on the risk of LN metastasis in pT1b sm1 EAC are still limited and mostly derive from retrospective surgical series [21][22][23][24][26][27][28][29][30][31]. In general, curative ET would only appear to be indicated on the condition that the rate of LN metastasis lies below the known mortality rate of radical esophagectomy in expert centers (2-5 %) which has so far been the therapeutic gold standard.…”

Multimodale Therapie mit kurativem Ansatz

“…Rate der Lymphknotenmetastasen deutlich an, sodass die chirurgische Resektion mit Lymphadenektomie gefordert werden muss [8,10]. Bei pT1-sm3-Karzinomen ist sogar aufgrund der gleichen Prognose wie bei pT2 die neoadjuvante Therapie zu erwägen [8].…”

“…Bei pT1-sm3-Karzinomen ist sogar aufgrund der gleichen Prognose wie bei pT2 die neoadjuvante Therapie zu erwägen [8].…”