ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2009
Transthoracic esophagectomy after endoscopic mucosal resection in patients with early esophageal carcinoma.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Endoscopic and surgical resection of T1a/T1b esophageal neoplasms: a systematic review.World journal of gastroenterology · 2013Pooled it
- [Carcinoma of the esophagus, esophagogastric junction, and stomach. Cooperation between pathology and surgery].Der Pathologe · 2012Review
- How radical should surgery be for early esophageal cancer?World journal of surgery · 2011Article
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Authors and funding
8 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionFor patients with esophageal carcinoma limited to the mucosa endoscopic mucosal resection (EMR) is the therapy of choice whereas surgical resection is advocated for submucosal tumors.
methodsThis study analyzes the histopathologic results of patients with early esophageal carcinoma who underwent EMR prior to transthoracic esophagectomy. Sixteen patients with early esophageal carcinoma and EMR as first line treatment were included in this retrospective study. Ten patients underwent transthoracic esophagectomy because of submucosal infiltration combined incomplete tumor resection at the lateral/basal resection margin. In one patient each, surgical therapy was indicated due to submucosal infiltration or incomplete resection only. Three patients underwent surgical resection due to residual neoplasia within an esophageal stenosis following EMR. Surgical specimens were examined for pT and pN stage according to the UICC.
resultsThree patients had a squamous cell carcinoma (SCC) and 13 patients an adenocarcinoma (AC), nine patients with a long segment Barrett's esophagus. The distribution of the pT stages was as follows: 6x pT0 (no histopathologic evidence of residual tumor), 1x pT1m1, 1x pT1m2, 3x pT1m3, 1x pT1sm1, 1x pT1sm2, 1x pT2, and 2x pT3. Three of 16 patients (18.8%) with a pT1sm1, pT2, and pT3 stage had nodal metastases. In all three patients metastatic nodes were located in the mediastinum. In two patients, a second carcinoma was detected during histopathologic work-up (1x AC in the cardia and 1x SCC in the cervical esophagus).
conclusionThe data of this highly selected patients indicate that the boundary between the therapy of mucosal and submucosal tumors is not as clear as stated. Therefore, treatment of early esophageal carcinoma demands a close interdisciplinary cooperation.
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