Can the Risk of Lymph Node Metastases Be Gauged in Endoscopically Resected XXXX ? A Multi-Center Study.

@entity1 @entity5 @entity418 @entity3 @entity420
UNASSIGNED: Endoscopic resection (ER) allows for local therapy of superficial @entity418 . Factors reported to be associated with an increased risk of lymph node @entity3 in @entity1 with @entity420 are poor differentiation, lymphovascular invasion (LVI), and @entity3 >500   . The aim of this study was to determine whether depth of invasion and @entity5 characteristics in an ER specimen can be used to gauge the risk of lymph node @entity3 in @entity1 with superficial @entity420 . @entity1 from seven US centers that had ER of an @entity420 followed by an esophagectomy were identified. The ER pathology slides were rereviewed by three experienced GI pathologists for depth of invasion, presence of LVI, and @entity5 differentiation. The findings from the ER specimen were correlated with the presence and number of lymph node @entity3 in the final esophagectomy specimen. There were 19 T1a and 23 T1b @entity5 . A median of 24 nodes were resected per @entity1 . None of the T1a @entity5 had involved lymph nodes despite the presence of LVI in 5  % and poor differentiation in 21  % of @entity1 . In contrast, 26  % of T1b @entity5 had involved nodes. None of the four @entity1 with @entity3  <=500   , no LVI, and no poor differentiation had involved nodes. However, with an increasing number of risk factors, the likelihood of involved lymph nodes increased, reaching 50  % when all three factors were present. Endoscopic therapy appears appropriate for @entity5 and may be an option for low-risk T1b @entity5 . Esophagectomy is preferred for @entity1 with @entity3 and one or more risk factors.
