Surgical Endoscopy

, Volume 32, Issue 1, pp 367–375 | Cite as

Clinical implication of endoscopic gross appearance in superficial esophageal squamous carcinoma: revisited

  • Cheal Wung Huh
  • Da Hyun JungEmail author
  • Jie-Hyun Kim
  • Dae Won Ma
  • Young Hoon Youn
  • Hyojin Park



Standard endoscopic appearance is essential for the diagnosis and treatment of superficial esophageal squamous carcinoma (SESC). The aim of this study was to investigate the association between the endoscopic gross appearance and the clinicopathologic characteristics of SESC.


We retrospectively analyzed the clinicopathologic characteristics of SESC according to gross endoscopic appearance in 275 patients with SESC that underwent esophagectomy or endoscopic resection (ER).


The proportion of type I or type III gross appearance, and that of types IIa, IIb, or IIc, were 26.2 and 73.8%, respectively. Type I or type III gross appearance was significantly associated with the female sex, submucosal invasion, lymphovascular invasion (LVI), and lymph node metastasis (LNM). In addition, younger age, larger tumor size, higher proportion of circumferential extension, type I or type III endoscopic gross appearance, submucosal invasion, moderate or poorly differentiated carcinoma, and LVI were significantly associated with LNM. Multivariate logistic regression analysis determined that independent predictors of LNM in patients with SESC included endoscopic gross appearance, submucosal invasion, and presence of LVI. Additionally, type I or type III endoscopic gross appearance lesions were more likely to have submucosal invasion than types IIa, IIb, or IIc. Risk factors for submucosal invasion included a gross appearance of type I or type III, moderately or poorly differentiated tumors, and presence of LVI.


We found that SESC clinical features are correlated with the endoscopic appearance. Therefore, we suggest that the endoscopic gross appearance may be a candidate for additive criteria in the indications for ER.


Superficial esophageal squamous cell carcinoma Lymph node metastasis Gross appearance 


Compliance with ethical standards


Drs. Cheal Wung Huh, Da Hyun Jung, Jie-Hyun Kim, Dae Won Ma, Young Hoon Youn, and Hyojin Park have no conflicts of interest or financial ties to disclose.

Supplementary material

464_2017_5685_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 14 kb)


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Cheal Wung Huh
    • 1
  • Da Hyun Jung
    • 2
    Email author
  • Jie-Hyun Kim
    • 2
  • Dae Won Ma
    • 2
  • Young Hoon Youn
    • 2
  • Hyojin Park
    • 2
  1. 1.Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Incheon St. Mary’s HospitalThe Catholic University of KoreaIncheonSouth Korea
  2. 2.Department of Internal Medicine, Gangnam Severance HospitalYonsei University College of MedicineSeoulSouth Korea

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