Special Issue of Diagnosis and Treatment of Early Tracheoesophageal Cancer Standard Treatments of Early Cancer of the Esophagus

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  • Yoshida Misao
    Ebara Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation
  • Momma Kumiko
    Department of Endoscopy, Tokyo Metropolitan Komagome Hospital
  • Izumi Yosuke
    Department of Surgery, Tokyo Metropolitan Komagome Hospital

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Other Title
  • 気管食道領域の早期癌の診断と治療　　早期食道癌の治療
  • 早期食道癌の治療
  • ソウキ ショクドウガン ノ チリョウ
  • Standard Treatments of Early Cancer of the Esophagus

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Abstract

Early esophageal cancer can be defined as a cancer with invasion confined to the mucosa. A cancer at this stage seldom has lymph node metastasis and can be identified as a mucosal lesion that has slight elevation (type 0-IIa), slight depression (type 0-IIc) or is completely flat (type 0-IIb). Mucosal cancer can be differentiated from submucosal cancer when the gross classification is applied, for submucosal cancer has a distinct elevation (type 0-I) or remarkable depression (type 0-III). Endoscopic mucosal resection (EMR) is recommended as the standard treatment for a mucosal cancer because of low incidence of lymph node metastasis. In the case of submucosal cancer, radical esophagectomy with lymph node dissection is recommended, owing to their frequent lymph node metastasis (30-50%). Although chemoradiotherapy (CRT) has been reported as another effective measure for treatment of superficial esophageal cancer, adverse effects due to later complications such as radiation pneumonitis, pericarditis and pleuritis have not yet been studied.

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