Abstract
To analyze the clinicopathological features and outcome of patients with pathologically proven superficial squamous cell carcinoma of the esophagus. A total of 234 consecutive cases of esophageal carcinoma in a 15-year period were reviewed. Superficial esophageal cancer was found in five patients (2.1%). They were four men and one woman and the mean age was 52.5 years. Smoking and alcohol were the main risk factors. Achalasia due to Chagas disease occurred in one patient and a second primary tumor developed in the larynx in another patient. Four patients underwent esophagectomy and one patient received chemoradiotherapy. The histopathologic diagnosis was of squamous cell carcinoma in all cases. Intramucosal tumor (Tis) was identified in three cases and superficially invasive carcinoma in two cases. Four patients are free of disease with survival times of two, four, six and nine years. The patient who developed laryngeal cancer died six years after esophagectomy. Long-term survival in patients with esophageal cancer is related to early diagnosis. Therefore, a less aggressive surgical approach, such as endoscopic resection, may be a good option for these patients, if depth of tumor invasion can be accurately predicted by the new imaging tools.
Highlights
The outcome of patients with esophageal cancer remains dismal with 5-year survival about 10% despite advances in diagnosis, staging and therapeutic procedures[1,2,3]
The clinicopathological features of the patients with superficial esophageal cancer are summarized on Table 1
We have found that only 2.1% of all patients surgically treated for esophageal carcinoma (n=234) presented the lesion at early stage
Summary
The outcome of patients with esophageal cancer remains dismal with 5-year survival about 10% despite advances in diagnosis, staging and therapeutic procedures[1,2,3]. This high mortality rate has been mainly related to late diagnosis[1,2,4]. New types of endoscopic techniques, including magnifying endoscopy, narrow-band imaging (NBI) and endocytoscopy are promising tools for detection of neoplastic lesions at early stage[6,14,15,16]
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