Search

The Japanese Society for Esophageal Cancer has defined mucosal and submucosal cancer as superficial cancer of the esophagus. Superficial cancer without metastasis was defined as early cancer of the esophagus. Of 104 cases of superficial cancer resected in these twenty years, early cancer was 62 cases, the incidence being 4.9% of all resected cases. The operative mortality rate and 5-year-survival rate of early cancer were 1.9% and 62%, respectively. As for the depth of the cancerous invasion, 14 of 104 superficial cancer cases were mucosal cancer. Twelve of 14 mucosal cancer belonged to early cancer. Vascular invasion was noted in one of 12 early mucosal cancer cases. No cancer death has been encountered in the early mucosal cancer cases. So the discovery of the mucosal cancer is mandatory to obtain the excellent results. For this purpose the value of endoscopy including the dying method, should be emphasized. In terms of treatment of the early cancer no special surgical procedure has been considered. The lymph node dissection has been carried out systematically. Some kinds of postoperative combined treatments are performed for early cancer cases with vascular invasion. The reduction surgery and the noninvasive treatment will be advisable for the small mucosal lesions.

Effect of Photodynamic therapy (PDT) for esophageal cancer was discussed in this study. PDT has been performed on 9 cases of superficial esophageal cancer. All cases were followed periodically by endoscopy for 2 years 2 months to 6 years and no case has any local recurrence. But in 2 cases invaded submucosal layer, lymph node metastasis was recognized. We think PDT is one of the very effective therapies in the treatment of intramucosal cancer.