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

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Abstract

Background

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.

Methods

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).

Results

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.

Conclusions

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.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, South Korea

    Cheal Wung Huh

  2. Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, South Korea

    Da Hyun Jung, Jie-Hyun Kim, Dae Won Ma, Young Hoon Youn & Hyojin Park

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  1. Cheal Wung Huh
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  2. Da Hyun Jung
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Correspondence to Da Hyun Jung.

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Disclosures

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.

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Huh, C.W., Jung, D.H., Kim, JH. et al. Clinical implication of endoscopic gross appearance in superficial esophageal squamous carcinoma: revisited. Surg Endosc 32, 367–375 (2018). https://doi.org/10.1007/s00464-017-5685-8

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  • DOI: https://doi.org/10.1007/s00464-017-5685-8

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