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KMID : 1038120140470060523
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Clinical Endoscopy
2014 Volume.47 No. 6 p.523 ~ p.529
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Lymph Node Metastases in Esophageal Carcinoma: An Endoscopist’s View
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Cho Jin-Woong
Choi Suck-Chei
Jang Jae-Young
Shin Sung-Kwan
Choi Kee-Don
Lee Jun-Haeng
Kim Sang-Gyun
Sung Jae-Kyu
Jeon Seong-Woo
Choi Il-Ju
Kim Gwang-Ha
Jee Sam-Ryong
Lee Wan-Sik
Jung Hwoon-Yong
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Abstract
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One of the most important prognostic factors in esophageal carcinoma is lymph node metastasis, and in particular, the number of affected lymph nodes, which influences long-term outcomes. The esophageal lymphatic system is connected longitudinally and transversally; thus, the pattern of lymph node metastases is very complex. Early esophageal cancer frequently exhibits skipped metastasis, and minimal surgery using sentinel node navigation cannot be performed. In Korea, most esophageal cancer cases are squamous cell carcinoma (SCC), although the incidence of adenocarcinoma has started to increase recently. Most previous reports have failed to differentiate between SCC and adenocarcinoma, despite the fact that the Union for International Cancer Control (7th edition) and American Joint Committee on Cancer staging systems both consider these separately because they differ in cause, biology, lymph node metastasis, and outcome. Endoscopic tumor resection is an effective and safe treatment for lesions with no associated lymph node metastasis. Esophageal mucosal cancer confined to the lamina propria is an absolute indication for endoscopic resection, and a lesion that has invaded the muscularis mucosae can be cured by local resection if invasion to the lymphatic system has not occurred.
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KEYWORD
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Esophageal neoplasms, Lymph node metastasis, Endoscopic resection
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