[Clinicopathological study on the intramural metastasis of the esophageal cancer]

Intramural metastasis and microscopical lymphatic permeation (distant-ly) distant more than 5mm from primary lesion were evaluated clinicopathologically in 207 patients with esophageal cancer, to reveal intramural lymphatic metastasis in esophageal cancer. Thirty-one lesions of intramural metastasis in 21 patients (10%) and 85 distant-ly lesions in 19 patients (9%) were observed. Both lesions existed mainly in lpm or sm layer and located within 5cm from primary lesion. As a direction of metastasis, intramural metastasis existed almost equivalently oral and anal from primary lesion, but distant-ly existed slightly more frequently in anal direction. When intramural metastatic lesion was recognized oral from primary lesion, lymph node involvement of the upper mediastinum was present in 67% of cases. On the other hand, intramural metastasis was seen anal from primary lesion and lymph node involvement of upper paragastric region was present in 100% of cases. Patients with intramural metastasis showed poor prognosis of one year of 50% survival period.