Pathology of Early Invasive Adenocarcinoma of the Esophagus or Esophagogastric Junction -- Implications for Therapeutic Decision Making

Johanna W. van Sandick, J. Jan B. van Lanschot, Fiebo J. W. ten Kate, et al.
Abramson Cancer Center of the University of Pennsylvania
Ultima Vez Modificado: 1 de noviembre del 2001

Share article


Reviewers: Li Liu, MD
Source: Cancer, Volume 88:2429-2437, (June) 2000

Précis: Esophagectomy remains the preferred treatment for early esophageal cancer


The treatment of esophageal cancer remains a challenge. Controversy persists regarding the optimal surgical approach to this disease. Tumors confined to the mucosa and submucosa, without metastases to the regional lymph nodes, both esophagectomy and endoscopic ablation are used for cure. In this report, the researchers evaluated the pathologic features of early adenocarcinoma of esophagus in an attempt to rationalize therapeutic decision making.


Pathology reports and slides of 173 patients who had esophagectomies for invasive adenocarcinoma were reviewed.


  • 19% of patients had early stage cancer.
  • 7% of patients had tumor invasion limited to the mucosa. Of them, no lymph node metastases were found.
  • 12% had tumor that invaded the submucosa. Lymph node metastases were present in 30% of them.
  • Intestinal metaplasia was present in all the cases.
  • The 3-year cause-specific survival for patients with intramucosal cancer was 100% and survival was 82% for patients with submucosa cancer.


Because staging techniques are inaccurate, the differences between the early stages of esophageal cancer remain unclear. Therefore, endoscopic treatment for clinically staged early esophageal cancer should be used with caution. For patients with submocosal extension, esophagectomy is preferred because of the relatively high incidence of lymph node metastasis.


I Wish You Knew

How cancer patients have changed my life

View More

Blogs and Web Chats

OncoLink Blogs give our readers a chance to react to and comment on key cancer news topics and provides a forum for OncoLink Experts and readers to share opinions and learn from each other.

OncoLink OncoPilot

Frente a un nuevo diagnóstico de cáncer o de cambiar el curso de su tratamiento actual? Deje que nuestro personal de enfermería cáncer que ayudan a pasar!

Más información