Superficial carcinomas of the esophagus and gastric cardia. A clinicopathological analysis of 141 cases.

From January 1970 to June 1992, 141 patients with superficial esophageal and cardiac carcinomas (SEC and SCC) underwent surgical treatment. Of the 141 patients 128(90.8%) had slight symptoms related to swallowing, and the remaining 13(9.2%) were asymptomatic. Balloon cytology and esophagoscopy proved very useful for the diagnosis of SEC and SCC, and Lugol's solution staining technique was an effective auxiliary diagnostic measure. Lymph node metastasis was not found in patients with epithelial (EP) cancer. However, it was present in one (2.9%) of 34 patients with muscularis mucosal (MM) invasion, and in 5 (8.6%) of 58 patients with submucosal (SM) cancer. The 5-year survival rates of the patients with SEC and SCC were 75.5% and 71.4%, respectively (P > 0.05). The different depth of tumor invasion including EP, MM and SM cancers showed significant differences in the 5-year survival rate (P < 0.05). Although the prognosis for the patients with lymph node metastasis is poor, we should advocate extended lymph node dissection in surgical treatment of the patients in whom MM and SM cancers are suspected.