Indications for Endoscopic Mucosal Resection (EMR) of a Superficial Carcinoma of the Esophagus

 

Indications - both of the following:

(1) well-differentiated or moderately differentiated squamous cell carcinoma

(2) in situ or limited to the lamina propria

 

Contraindications - any of the following:

(1) poorly differentiated squamous cell carcinoma

(2) extension beyond the muscularis mucosae

(3) venous and/or lymphatic invasion

(4) circumferential growth (due to risk of post-operative stricture formation)

 

where:

• Histologic types other than squamous cell are not specified.

• The role of treating early adenocarcinoma in the setting of Barrett's esophagus has not been established (Soetikkno, page 4491).

Depth of Invasion	Percent Lymph Node Metastasis
in situ	0%
lamina propria	3%
muscularis mucosae	12%
submucosa	26%