Early ‐stage adenocarcinoma of the esophagus with mid to deep submucosal invasion (pT1b sm2‐3): the frequency of lymph‐node metastasis depends on macroscopic and histological risk patterns

Summary The rate of lymph‐node (LN) metastasis in early adenocarcinoma (EAC) of the esophagus with mid to deep submucosal invasion (pT1b sm2/3) has not yet been precisely defined. The aim of the this study was to evaluate the rate of LN metastasis in pT1b sm2/3 EAC depending on macroscopic and histological risk patterns to find out whether there may also be options for endoscopic therapy as in cancers limited to the mucosa and the upper third of the submucosa. A total of 1.718 pt with suspicion of EAC were referred for endoscopic treatment (ET) to the Dept. of Internal Medicine II at HSK Wiesbaden 1996–2010. In 230/1.718 pt, the suspicion (endoscopic ultrasound, EUS) or definitive diagnosis of pT1b EAC (ER/surgery) was made. Of these, 38 pt had sm2 lesions, and 69 sm3. Rate of LN metastasis was analyzed depending on risk patterns: histologically low‐risk (hisLR): G1‐2, L0, V0; histologically high‐risk (hisHR): ≥1 criterion not fulfilled; macroscopically low‐risk (macLR): gross tumor type I‐II, tumor size ≤2 cm; macroscopically high‐risk (macHR): ≥1 criterion not fulfilled; combined low‐risk (combLR): hisLR+macLR; combined high‐risk (combHR): at least 1 risk factor. LN rate was only evaluated in pt who had proven maximum invasion depth of sm2/sm3, and who in case of ET had a follow‐up (FU) by EUS of at least 24 months. 23/38 pt with pT1b sm2 lesions and 39/69 pt with sm3 lesions fulfilled our inclusion criteria. In the pT1b sm2 group, rate of LN met...
Source: Diseases of the Esophagus - Category: Gastroenterology Authors: Tags: Original Article Source Type: research