Assessment of proximal extent of spread in squamous cell carcinoma esophagus
Journal Title: Medpulse International Journal of Surgery - Year 2018, Vol 6, Issue 3
Abstract
Background: Carcinoma of the esophagus is a devastating disease with adverse effects on swallowing and quality of life. The two most important prognostic factors for esophageal cancer are the depth of penetration and the nodal involvement. Aim: To assess the proximal extent of spread in squamous cell carcinoma esophagus. Material and Methods: Surgical specimens from 45 patients with Esophageal Squamous Cell Carcinoma who underwent Transhiatalesophagectomy were collected prospectively for study. The in situ length of esophagus from the proximal margin of the tumor to the proposed line of division measured first. Similarly, the length of resected specimen measured after stretching it in a corkboard to assess the percentage of shrinkage. Results: Among the 45 patients, in 4 patients the proximal extent of spread was <5mm, 28 patients it was 5 to 10 mm and in 13 atients it was >10mm. The maximum extent of proximal spread in our study was 15 mm. Mean proximal spread in our study group was 8.5 mm. When we compared the T-stage and the proximal spread, among the 28 T2 tumours,<5 mm proximal spread found in 4 patients and > 5 mm proximal spread in 24 patients. Among the 17 T3 lesions, all were found to have > 5 mm proximal spread. 10 of the T2 lesions found to have > 10 mm proximal spread, similarly 4 of the T3 lesions found to have > 10 mm proximal spread. Conclusion: To achieve consistently negative proximal resection margins we recommend resection of a minimum of 2 cm of macroscopically normal foregut above the proximal margin of the primary tumor
Authors and Affiliations
A Prabhakaran, Chandramohan 2, Naganath babu, Selvaraj 4, Amuthan 5, Ilango 6
Keywords
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