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Endoscopic classification of superficial esophageal cancer



Endoscopic classification of superficial esophageal cancer



Stomach & Intestine (Tokyo) 22(12): 1343-1348



In analyzing the depth of superficial cancer related to nodal involvement and to vascular invasion, 16 out of 19 cases of mucosal cancer (84%) had neither nodal involvement nor vascular invasion. In contrast, 31 out of 104 cases of submucosal cancer (28%) had neither nodal involvement nor vascular invasion. The 5-year survival rate of the patients with superfical cancer with and without lymph node metastasis were 22% and 68%, respectively. The 5-year survival rate of the patients with mucosal cancer were 100%, while that for submucosal cancer without nodal involvement was 71%. Based on these data, long-term survival is expected to be excellent in most cases of mucosal cancer. Superficial cancer of the esophagus is classified endoscopically as follows: 0-I (superficial and protruded type), 0-IIa (slightly elevated type), 0-IIb (flat type), 0-IIc (slightly depressed type), 0-III (superficial and excavated type), and 0-V (superficial and unclassified type). The advanced esophageal cancer is classified into 5 types endoscopically, i.e., 1 (protruded type), 2 (well-defined excavated type), 3 (ill-defined excavated type), 4 (diffusely infiltrating type) and 5 (unclassified type). Previous data from the endoscopic study on superficial cancer, the polypoid and the plateau-like types were mostly submucosal cancer. The ulcerative type was also submucosal cancer. Only the flat and the erosive lesions were mucosal cancer. According to the endoscopic classification of superficial cancer described above, mucosal cancer is expected to be in the type 0-IIa, 0-IIb or 0-IIc.

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