Clinical Study on Esophageal Cancer Recognized Radiologically as Stenosis

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  • Uematsu Sadao
    The Second Department of Surgery, School of Medicine, Chiba University
  • Sato Hiroshi
    The Second Department of Surgery, School of Medicine, Chiba University
  • Isono Kaichi
    The Second Department of Surgery, School of Medicine, Chiba University
  • Ryu Munemasa
    The Second Department of Surgery, School of Medicine, Chiba University
  • Furukawa Takao
    The Second Department of Surgery, School of Medicine, Chiba University
  • Watanabe Yoshiji
    The Second Department of Surgery, School of Medicine, Chiba University
  • Imasono Osamu
    The Second Department of Surgery, School of Medicine, Chiba University
  • Kikuchi Toshiyuki
    The Second Department of Surgery, School of Medicine, Chiba University

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Other Title
  • X線上狭窄所見を認めた食道癌の検討
  • X センジョウ キョウサク ショケン オ ミトメタ ショクドウガン ノ ケント

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Abstract

Radiological findings of esophageal cancer are usually recognized by tumor-shadow, fillings defect, malignant fold, rigidity and irregularity of the esophageal wall, malignant crater and stenosis, but malignant stenosis in esophageal cancer has not been reported in detail. In this paper, 129 cases of resected esophageal cancer with malignant stenosis observed at the 2nd Surgical Department of Chiba University are discussed in detail.<br>The grades of stenosis are divided into three stages, grade I stenosis: 3/4<d′/d≤1/2; grade II stenosis: 1/4≤d′/d<1/2; and grade III stenosis: d′/d<1/4. d′ is the diameter of the stenosis of the esophageal cancer and d is the diameter of the normal esophagus radiologically.<br>These three grades of stenosis are discussed with regard to the location of lesion, horizontal location, vertical extent, X-ray type (superficial, tumorous, serrated, funnelled and spiral according to guidelines in clinical and pathological studies for carcinoma of the esophagus, early (sm), superficial (a0), intermediate (a1, 2) and deep infiltrative (a3) type which depends upon the infiltrative histological depth), effects of the preoperative combined therapy on the esophageal cancer, macroscopic findings of the resected esophagus and prognosis. There were 39 cases of grade I stenosis (30%), 75 cases of grade II stenosis (58%) and 15 cases of grade III stenosis (12%) among the 129 cases.<br>Radiological findings associated with stenosis in esophageal cancer are rigidity and irregularity of the esophageal wall, penetration, perforation, and windings. These severe radiological findings are most recognizable in grade II or grade III stenosis. Spiral type findings are recognized in all grades of stenosis.<br>As the X-ray type depends upon the infiltrative histological depth, there were no cases of early type (sm) at any grade of stenosis. There tivere only one case each in grades I and II of superficial type. Intermediate type and deep infiltrative type are recognizable at all three stage.<br>Survival rates for five years were 20% for grade I, 12% for grade II, 0% for grade III and 14% overall.

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