[Treatment of superficial carcinoma of the esophagus--a review of responses to questionnaire on superficial carcinoma of the esophagus collected at the 49th conference of Japanese Society for Esophageal Diseases].

Histopathological characteristics and optimal treatment modality for superficial esophageal carcinoma were reevaluated by the way of nationwide questionnaires to the members of the Japanese Society for Esophageal Diseases. A questionnaire was designed for patients with preoperatively untreated superficial carcinoma of the esophagus who had undergone either surgical or endoscopic treatment between January 1, 1990 and December 30, 1994. As the results, the incidence of positive lymphatic invasion or lymphnode metastases tended to increase markedly as cancer infiltration reached the lamina muscularis mucosa. The majority of the cases with 0-I or 0-III components were sm. cancer. The indication of endoscopic mucosal resection (EMR) was limited to m1 and m2 superficial carcinoma in 76% of the institutions surveryed. Tumors measuring 2cm or more in diameter were resected piecemeal in 94% of the patients. The complications of EMR were observed in approximately 6.8% of patients, which denoted perforation, stenosis, and hemorrhage on most of the cases. As for the result of the treatment, almost all patients with m1 or m2 cancer survived. There was no significant difference in prognosis between m3 cancer and m1 or m2 cancer, but sm1 cancer showed worse prognosis than mucosal carcinoma. From this review, further study was advocated to refine the treatment strategy against m3 or sm1 cancer in the future.