Can the depth of invasion of early esophageal cancer be predicted based on endoscopic evidence?

Autor: Rehan Haidry, Sielte Maes, Raf Bisschops
Rok vydání: 2018
Předmět:
medicine.medical_specialty
Esophageal Neoplasms
Endoscopic mucosal resection
Adenocarcinoma of esophagus
CLASSIFICATION
Metastasis
Lesion
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Esophageal squamous cell carcinoma
MANAGEMENT
Carcinoma
Humans
Medicine
Neoplasm Invasiveness
Neoplasm Staging
EARLY ADENOCARCINOMA
Science & Technology
medicine.diagnostic_test
business.industry
LYMPH-NODE METASTASIS
Endoscopy
Esophageal cancer
medicine.disease
RANDOM BIOPSIES
EARLY BARRETTS NEOPLASIA
SPECIALIZED INTESTINAL METAPLASIA
Depth of invasion
Esophageal neoplasms
030220 oncology & carcinogenesis
Predictive value of tests
HIGH-GRADE DYSPLASIA
Neoplasm staging
030211 gastroenterology & hepatology
Surgery
Esophagoscopy
SQUAMOUS-CELL CARCINOMA
MAGNIFICATION ENDOSCOPY
Radiology
medicine.symptom
business
Life Sciences & Biomedicine
Zdroj: Minerva Surgery. 73
ISSN: 2724-5438
2724-5691
DOI: 10.23736/s0026-4733.18.07760-x
Popis: INTRODUCTION: Esophageal cancer is one of the leading causes of cancer-related death worldwide. Its poor prognosis is related to an often late diagnosis. An earlier diagnosis and treatment however, is related to a better outcome. Early stage esophageal cancer can be diagnosed and treated endoscopically with minimally invasive techniques, which is associated with lower mortality and morbidity than surgery. Whether esophageal carcinoma can be treated endoscopically depends mainly on the risk of lymph node metastasis, which itself correlates to the invasion depth of the tumor. The question is whether endoscopy can accurately determine the invasion depth and thus the treatment modality. EVIDENCE ACQUISITION: Articles used for this review were identified by searches of PubMed and references of relevant articles. EVIDENCE SYNTHESIS: Lesion morphology has some predictive value for the depth of invasion for squamous cell carcinoma (SCC) and esophageal adenocarcinoma (EAC). An intramucosal cancer generally has a flat appearance (Paris 0-IIa, 0-IIb,). By contrast, a submucosally invasive cancer often has an excavated (0-IIc, 0-III) and sometimes a polypoid morphology (0-I). In SCC, classification of surface vessels and intrapapillary capillary loops (IPCLs) allows accurate assessment of invasion depth. Generally, mucosal lesions are an indication for endoscopic treatment. However recent studies have shown that tumors with submucosal infiltration and low risk profile for metastasis can also be treated safely by endoscopic resection. CONCLUSIONS: Endoscopic assessment allows a rather accurate estimation of invasion depth of early esophageal cancer. To determine the final treatment modality however the final histological staging obtained by endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) is crucial. ispartof: MINERVA CHIRURGICA vol:73 issue:4 pages:385-393 ispartof: location:Italy status: published
Databáze: OpenAIRE
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