Proposed new criteria for early carcinoma of the esophagus.

The criteria of early carcinoma of the stomach, defined in 1981, has gained worldwide acceptance. A few proposals of a criteria for early carcinoma of the esophagus have been made; however, these criteria have not been internationally accepted, as the rate of recurrence is high in patients with early carcinoma of the esophagus, as determined by these criteria. In patients with submucosal carcinoma of the esophagus, metastasis to lymph nodes was present in 32.5 per cent at the time of the operation, and the five year survival rate was only 54.5 per cent. On the other hand, while the incidence of epithelial or mucosal carcinoma, or both, is only 2.2 per cent (46 of 2,130) in patients with carcinoma of the esophagus, the incidence has been remarkably increased and the five year cumulative survival rate for patients with epithelial carcinoma or mucosal carcinoma, or both, is now 88.4 per cent. Thus, we consider that the criteria for early carcinoma of the esophagus to be mucosal carcinoma as well as epithelial carcinoma regardless of the presence or absence of lymph node metastasis, and that a submucosal carcinoma should be excluded from the classification of early carcinoma of the esophagus.