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Comprehensive pathological evaluation of risk factors for metastasis after endoscopic resection of superficial esophageal squamous cell carcinoma

  • 0Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan. ryu1486@gmail.com.
Journal of Gastroenterology +

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November 26, 2024

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November 26, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Lymphovascular invasion (LVI) and depth of invasion are key predictors of metastasis in esophageal squamous cell carcinoma (ESCC) after endoscopic resection. Accurate pathological assessment is vital for guiding patient treatment strategies.

Area Of Science

  • Oncology
  • Gastroenterology
  • Pathology

Background

  • Esophageal cancer poses a significant global mortality risk.
  • Endoscopic resection (ER) offers curative treatment for esophageal squamous cell carcinoma (ESCC).
  • Predicting metastasis risk post-ER is crucial for patient management.

Purpose Of The Study

  • To identify predictors of metastasis in patients with ESCC treated with ER.
  • To evaluate pathological features of resected specimens for metastasis risk assessment.

Main Methods

  • Retrospective multicenter study of 422 ESCC patients undergoing ER (1994-2017).
  • Inclusion criteria: pT1a or pT1b submucosal invasive cancer.
  • Pathological review assessed depth of invasion, lymphovascular invasion (LVI), droplet infiltration (DI), and other factors; logistic regression used for analysis.

Main Results

  • Metastasis observed in 103 patients.
  • Multivariate analysis identified LVI, pT1b-SM2 invasion depth, and indeterminate vertical margin as independent predictors of metastasis.
  • No significant association found between metastasis and lesion size, differentiation, or infiltration pattern.

Conclusions

  • Lymphovascular invasion (LVI) and depth of invasion (pT1b-SM2, indeterminate margin) are significant predictors of metastasis in ESCC.
  • Detailed pathological evaluation using standardized criteria is essential for accurate metastasis risk assessment and post-ER treatment planning.

Keywords:

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