Table 4 Patients with positive deep margins (n = 10)
Adenocarcinoma Stage | Tumor morphology | Deep margin | Follow-up | |
|---|---|---|---|---|
Intramucosal | Low-risk features | Positive at site of tissue disruption with cautery effect | 6 month follow-up endoscopy and biopsies negative for carcinoma | |
Intramucosal | Low-risk features | Positive at the site of tissue disruption with cautery artifact | 11 month follow-up with no recurrent carcinoma, just BE with low-grade dysplasia treated with RFA | |
Intramucosal* | Low-risk features | Plane of resection “mucosal” at the site of positive deep margin | Esophagectomy showed residual tumor, pT1aN0 (AJCC/CAP staging, 8th edition) | |
Submucosal | High-risk features (DOI: sm2) | Tumor present at the edge of resection with both peripheral and deep margin positive | Esophagectomy showed residual tumor, pT1bN0 (AJCC/CAP staging, 8th edition) | |
Submucosal | Low-risk features | Plane of resection “mucosal” at the site of positive deep margin | 3 and 9-month endoscopy with biopsy of ESD scar site showed BE but no dysplasia or carcinoma | |
Submucosal | Low-risk features (High-grade tumor budding) | Tumor present at the edge of resection | Esophagectomy showed residual tumor, pT2N0 (AJCC/CAP staging, 8th edition) | |
Submucosal | High-risk features (DOI: sm2) | Plane of resection “mucosal” at the site of positive deep margin | Esophagectomy showed no residual tumor, pT0N0 (AJCC/CAP staging, 8th edition) | |
Submucosal** | High-risk features (Poorly differentiated tumor & Large-vessel invasion) | Positive deep margin | Referred for more chemoradiation | |
Submucosal** | High-risk features (Poorly differentiated Tumor, LVI present) | Positive deep margin | Referred for more chemoradiation | |
Submucosal | High-risk features (DOI: 980/1500 μm, sm2) | Single atypical gland in cauterized tissue at the deep margin | Esophagectomy showed residual tumor; pT1aN0 (AJCC/CAP staging, 8th edition) | |