The definition of early carcinoma of the esophagus was widely discussed in the past. At first it was defined as the condition that cancer is located in or beneath the submucosal layer without regard to the presence or absence of lymph node metastasis like in early gastric cancer. Later, in 1975, we used the term of early cancer only when lymph node metastasis was absent, as follow-up studies of surgically treated patients showed a worse prognosis in cases with positive nodes.
One hundred and seventy-seven cases of early cancer of the esophagus observed in Japan in the period from 1966 to 1979 were reviewed and statistical analysis was accomplished. Overall five-year survival rate was 75.9%, which is very satisfactory as compared with that of advanced esophageal cancer, which is below 20% in large Japanese series. In 17 cases only intraepithelial spread was observed and five-year survival rate was 100%.
These strongly support the idea that an effort should be done in order to diagnose esophageal cancers in the “early” or possibly in the intraepithelial stage.
