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Ishihara. Mini-invasive Surg 2021;5:36 https://dx.doi.org/10.20517/2574-1225.2021.72 Page 3 of 9
Figure 1. Diagnosis of lateral extent. (A) The lateral extent of the cancer was initially diagnosed using narrow-band imaging. (B) The
lateral extent was then confirmed by iodine staining.
INDICATIONS FOR ESD [Table 1]
Cancer invasion depth
The indication for ESD in patients with T1N0M0 esophageal SCC is determined mainly based on cancer
invasion depth and the lateral extent of the cancer. Clinically diagnosed (c)T1a-epithelial/lamina propria
(EP/LPM) cancers are considered good candidates for ESD and are thus regarded as an indication for ESD.
[13]
The committee for the Japanese ESD/endoscopic mucosal resection (EMR) Guidelines previously
discussed the validity of T1a-muscularis mucosae/T1b-submucosa 1 (MM/SM1) as an indication for ESD.
However, there is considerable discrepancy between (c)MM/SM1 and pathologically diagnosed
(p)MM/SM1, and these should thus be treated separately. The above committee discussed the validity of
(c)MM/SM1 as an indication for ESD.
