Esophageal Extension of Carcinoma of the Stomach

Abstract

On histologic examination of a total of 202 stomach cancer specimens of proximal resection or total gastrectomy, 102 cases or 50.6 per cent revealed esophageal invasion of carcinoma. In 94 cases with carcinoma in the upper third of the stomach, the incidence of esophageal invasion was as high as 65.9 per cent. Two principal routes were recognized in esophageal extension of stomach cancer: One was invasion through the submucosal lymphatics (observed in 43 cases, 42.2 per cent of the 102 cases) and the other was the extension of serosal involvement of stomach cancer into the serosa or fibrosa of the esophagus in the form of incipient carcinomatous peritonitis (34 cases, 33.3 per cent). There were also occasions that the esophagus had been involved by both of the above mechanisms. Most of the cases with esophageal invasion were associated with other manifestations of extragastric spread of carcinoma, e.g., peritoneal involvement and lymph node metastasis. However, the cases with solely sub-mucosal infiltration to the esophagus included a considerable number of ob-jectives of radical surgery that showed little or no evidence of other extragastric spread.