Esophageal Squamous Cell Carcinoma: Diagnosis and Treatment by Nobutoshi Ando

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By Nobutoshi Ando

Esophageal melanoma factors an predicted 386,000 deaths around the globe and is the 6th commonest reason for loss of life for males. The history features of esophageal melanoma remedy are markedly diversified among Asian and Western nations, although. In tumor histology, squamous mobilephone carcinoma linked to smoking and alcohol intake is overwhelmingly ordinary in Asia, while adenocarcinoma linked to Barrett’s metaplasia is markedly known within the West. In Asia, particularly in Japan, the foremost folks who play vital roles within the administration of esophageal melanoma sufferers are surgeons; within the West these roles are crammed by means of clinical and radiation oncologists in addition to surgeons. The philosophy of surgeons relating to melanoma surgical procedure varies from locoregional to neighborhood tumor keep watch over, quite in concentrating on lymph node dissection. Physicians’ method of surgical adjuvant remedy differs, accordingly, among Asia and the West. contemplating those East–West ameliorations in esophageal melanoma remedy, the at present to be had result of Western facts shouldn't be thought of at once appropriate to esophageal melanoma in Asia. during this publication, the authors talk about the information base in Japan when it comes to therapy of esophageal squamous mobilephone carcinoma. seeing that this quantity encompasses a vast spectrum of present details and addresses issues surrounding the remedy of sufferers with esophageal squamous telephone carcinoma, it really is hugely suitable to Asian physicians and researchers in addition to to their opposite numbers within the West.

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Takashima et al. proposed the second criteria: obliteration of the triangular fat space between the esophagus, aorta, and spine suggestive of aortic invasion (Fig. 15a). And they reported that both sensitivity (100 %) and specificity (86 %) for the MRI were high with such criteria; CT and MRI have the same accuracy in predicting resectability. In their study, no patients had a false-negative result (Figs. 9a) [28]. Ogawa et al. reported that the second criteria 3 Diagnostic Imaging of the Esophageal Cancer 49 Fig.

According to the Japanese classification of esophageal cancer [1–3], well-differentiated squamous cell carcinoma is characterized by extensive keratinization and stratified squamous differentiation, accounting for more than three quarters of the tumor area (Fig. 10), whereas poorly differentiated squamous cell carcinoma has such keratinization accounting for less than one quarter of the tumor area. Moderately differentiated squamous cell carcinoma lies between these two. The WHO classification states that grading is traditionally based on mitotic activity, nuclear atypia, and degree of squamous differentiation, with no special reference to the ratio of keratinization [4].

Histologically, typical basaloid squamous carcinomas are composed of relatively uniform, small, round-to-oval cells with scant cytoplasm forming a large solid tumor nest with comedo-like necrosis (Fig. 12). The tumor nest contains eosinophilic hyaline material, suggesting a basement membrane-like substance. Basaloid squamous carcinoma has been reported to have a wide variation of 2 Pathology of Esophageal Squamous Cell Carcinoma 27 Fig. 12 Typical histologic features of basaloid squamous carcinoma.

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