[Early squamous epithelial carcinoma of the esophagus--multicentricity, metastatic pattern and prognosis]

The results of surgical treatment of 65 patients with pT1 squamous cell carcinoma of the esophagus and the histologic workup of the specimens were analyzed. The treatment of choice was transthoracic enbloc esophagectomy (n = 45); in 16 patients with very distal carcinoma and restrained lung function transhiatal esophagectomy was performed. Two patients with concomitant early gastric carcinoma or lymphoma had total esophagogastrectomy, and in 2 other patients cervical esophagectomy was performed. The postoperative 30-day mortality was 6.1%. 74% of the cases had an infiltration of the submucosa, whereas in 26% the carcinoma was limited to the mucosa. No patients with mucosal carcinoma had lymph node metastases, whereas 23% of the patients with submucosal infiltration showed lymph node involvement. Tumors of other organs, especially stomach and hypopharynx, were found in 15.4% of the patients. The 5-year survival rate of the total group of 65 patients was 61.3%. As 3 patients with mucosal carcinoma died during long-term follow-up due to recurrence or second cancer, no significant prognostic difference was found between patients with mucosal or submucosal infiltration. The survival curves of patients with pN0 and those with pN1 tumors were not significantly different.