Prognostic factors in early esophageal cancer

During the period from 1975 through 1988, 405 thoracic esophageal carcinoma were resected in our department. Among them, superficial carcinoma was proved in 50 cases. The prognosis of these 50 patients with superficial carcinoma has been analyzed in regard to the prognostic factors. As for the clinico-pathological findings, there were no evident differences in mean age, sex distribution and main location of the lesions between superficial cases and overall resected cases. The distribution of depth of invasion was as follows; ep 4 cases, mm 7 cases and sm 39 cases. The number of patients with invasion to submucosal layer had included the majority of the superficial cases. Lymph node metastasis was proved in 17 cases, and 16 of them had the invasion to the submucosal layer. On the other hand, neither patient with invasion to ep layer had lymph node metastasis, however, in one of seven cases with invasion to mm layer, lymph node metastasis to second group node was proved. The lesions have been resected through thoracotomy in 48 patients out of 50 cases. Blunt dissection has been carried out upon only two cases. The 5-year survival rate of superficial carcinoma was 61.7%, which was clearly better than that of all patients resected in the same period (31.6%). The prognosis distinctly correlated with the depth of invasion; 5-year survival rate of ep, mm and sm cases were 100%, 83.7% and 54.3%, respectively. We experienced no recurrence in case of ep or mm. As for sm cases, lymph node metastasis and/or vessel invasion were most dominant prognostic factors.(ABSTRACT TRUNCATED AT 250 WORDS)