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Significance of involvement by squamous cell carcinoma of the ducts of esophageal submucosal glands
Author(s) -
Tajima Yusuke,
Nakanishi Yukihiro,
Tachimori Yuji,
Kato Hoichi,
Watanabe Hiroshi,
Yamaguchi Hajime,
Yoshimura Kimio,
Kusano Mitsuo,
Shimoda Tadakazu
Publication year - 2000
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(20000715)89:2<248::aid-cncr7>3.0.co;2-q
Subject(s) - submucosa , pathology , medicine , muscularis mucosae , lymphovascular invasion , lymphatic system , lymphatic vessel , esophagus , carcinoma , metastasis , lymph node , lesion , lymph , cancer , anatomy
BACKGROUND Ductal involvement (DI) is often observed in superficial squamous cell carcinoma of the esophagus (SSCCE), defined as carcinoma with invasion limited to the submucosa. The purpose of this study was to clarify the clinicopathologic significance of DI in SSCCE. METHODS Two hundred one surgically resected lesions from 140 patients with SSCCE were examined histopathologically. Clinicopathologic factors, such as macroscopic type, tumor location, maximum tumor size, depth of invasion, lymphatic and blood vessel permeation, lymph node metastasis, and prognosis, were examined to investigate the association between these factors and the presence of DI. RESULTS Of the 201 SSCCE lesions, 43 (21.3%) had 152 DIs (1–32 DIs per lesion). The DI always remained in situ, and there were no tumors showing submucosal invasion through the DI. As for the relation between clinicopathologic factors and the presence of DI, multivariate analysis showed only maximum tumor size to correlate with the presence of DI ( P < 0.0001). There were no significant differences between DI negative and DI positive lesions in tumor location, macroscopic type, lymphatic and blood vessel permeation, lymph node metastasis, or prognosis. In 83 mucosal carcinomas, including in situ carcinomas or carcinomas that invaded no deeper than the lamina muscularis mucosa, no lymph node metastasis was found, and the 5‐year survival rate was 100% (unaffected by the presence of DI). Among these 83 lesions, DI was found in 11 (13.8%), of which 6 (7.2%) had DI extending to the submucosal layer. CONCLUSIONS These results indicate that DI as a pathway of tumor spread to the deeper layer is of little significance in squamous cell carcinoma of the esophagus, and that mucosal carcinomas with DI that extends to the submucosa should not be classified as submucosal carcinoma. Cancer 2000;89:248–54. © 2000 American Cancer Society.