Endoscopic landmarks corresponding to anatomical landmarks for esophageal subsite classification

Abstract Objectives Individual treatment strategies for esophageal cancer have been investigated based on the anatomical subsite classification. Accurate subsite classification based on these anatomical landmarks is thus important. We investigated the suitability of the existing endoscopic classific...

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Main Authors: Ryu Ishihara, Yasuhiro Tani, Yuki Okubo, Yuya Asada, Tomoya Ueda, Daiki Kitagawa, Takehiro Ninomiya, Atsuko Tamashiro, Shunsuke Yoshii, Satoki Shichijo, Takashi Kanesaka, Sachiko Yamamoto, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Tomoki Michida
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:DEN Open
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Online Access:https://doi.org/10.1002/deo2.273
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author Ryu Ishihara
Yasuhiro Tani
Yuki Okubo
Yuya Asada
Tomoya Ueda
Daiki Kitagawa
Takehiro Ninomiya
Atsuko Tamashiro
Shunsuke Yoshii
Satoki Shichijo
Takashi Kanesaka
Sachiko Yamamoto
Yoji Takeuchi
Koji Higashino
Noriya Uedo
Tomoki Michida
author_facet Ryu Ishihara
Yasuhiro Tani
Yuki Okubo
Yuya Asada
Tomoya Ueda
Daiki Kitagawa
Takehiro Ninomiya
Atsuko Tamashiro
Shunsuke Yoshii
Satoki Shichijo
Takashi Kanesaka
Sachiko Yamamoto
Yoji Takeuchi
Koji Higashino
Noriya Uedo
Tomoki Michida
author_sort Ryu Ishihara
collection DOAJ
description Abstract Objectives Individual treatment strategies for esophageal cancer have been investigated based on the anatomical subsite classification. Accurate subsite classification based on these anatomical landmarks is thus important. We investigated the suitability of the existing endoscopic classification and explored alternative landmarks for esophageal subsite classification. Methods Patients who received endoscopic ultrasonography (and computed tomography scans for surveillance of esophageal cancer treatment or esophageal submucosal tumors were included. Distances between anatomical landmarks, including the inferior cricoid cartilage border, superior border of the sternum, and tracheal bifurcation, were measured using a combination of endoscopic ultrasonography, computed tomography, and other information. Results The mean (standard deviation) distances from the superior incisor dentition to the pharynx–esophagus, cervical–upper thoracic esophagus, and upper–middle thoracic esophagus boundaries were 16.9 (1.7), 21.7 (1.9), and 29.0 (1.9) cm, respectively. However, variances in the differences between the mean and individual distances were large (2.8, 3.4, and 3.7, respectively), mainly because of differences in body height. However, variances in the differences between individual distances and novel endoscopic landmarks, including the lower end of the pyriform sinus and lower end of compression of the left main bronchus, were lower (1.7, 1.2, and 0.6, respectively). Conclusions Existing indicators of esophageal subsite boundaries were not consistent with anatomical boundaries. Modification of the distance from the superior incisor dentition based on average distances from anatomical landmarks or the use of alternative endoscopic landmarks is recommended to provide more suitable anatomical boundaries.
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spelling doaj-art-b23b7f40bf89478da8f08a7e4071a54a2025-08-20T03:38:54ZengWileyDEN Open2692-46092024-04-0141n/an/a10.1002/deo2.273Endoscopic landmarks corresponding to anatomical landmarks for esophageal subsite classificationRyu Ishihara0Yasuhiro Tani1Yuki Okubo2Yuya Asada3Tomoya Ueda4Daiki Kitagawa5Takehiro Ninomiya6Atsuko Tamashiro7Shunsuke Yoshii8Satoki Shichijo9Takashi Kanesaka10Sachiko Yamamoto11Yoji Takeuchi12Koji Higashino13Noriya Uedo14Tomoki Michida15Department of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute OsakaJapanAbstract Objectives Individual treatment strategies for esophageal cancer have been investigated based on the anatomical subsite classification. Accurate subsite classification based on these anatomical landmarks is thus important. We investigated the suitability of the existing endoscopic classification and explored alternative landmarks for esophageal subsite classification. Methods Patients who received endoscopic ultrasonography (and computed tomography scans for surveillance of esophageal cancer treatment or esophageal submucosal tumors were included. Distances between anatomical landmarks, including the inferior cricoid cartilage border, superior border of the sternum, and tracheal bifurcation, were measured using a combination of endoscopic ultrasonography, computed tomography, and other information. Results The mean (standard deviation) distances from the superior incisor dentition to the pharynx–esophagus, cervical–upper thoracic esophagus, and upper–middle thoracic esophagus boundaries were 16.9 (1.7), 21.7 (1.9), and 29.0 (1.9) cm, respectively. However, variances in the differences between the mean and individual distances were large (2.8, 3.4, and 3.7, respectively), mainly because of differences in body height. However, variances in the differences between individual distances and novel endoscopic landmarks, including the lower end of the pyriform sinus and lower end of compression of the left main bronchus, were lower (1.7, 1.2, and 0.6, respectively). Conclusions Existing indicators of esophageal subsite boundaries were not consistent with anatomical boundaries. Modification of the distance from the superior incisor dentition based on average distances from anatomical landmarks or the use of alternative endoscopic landmarks is recommended to provide more suitable anatomical boundaries.https://doi.org/10.1002/deo2.273classificationendoscopyesophaguslandmarkpharynx
spellingShingle Ryu Ishihara
Yasuhiro Tani
Yuki Okubo
Yuya Asada
Tomoya Ueda
Daiki Kitagawa
Takehiro Ninomiya
Atsuko Tamashiro
Shunsuke Yoshii
Satoki Shichijo
Takashi Kanesaka
Sachiko Yamamoto
Yoji Takeuchi
Koji Higashino
Noriya Uedo
Tomoki Michida
Endoscopic landmarks corresponding to anatomical landmarks for esophageal subsite classification
DEN Open
classification
endoscopy
esophagus
landmark
pharynx
title Endoscopic landmarks corresponding to anatomical landmarks for esophageal subsite classification
title_full Endoscopic landmarks corresponding to anatomical landmarks for esophageal subsite classification
title_fullStr Endoscopic landmarks corresponding to anatomical landmarks for esophageal subsite classification
title_full_unstemmed Endoscopic landmarks corresponding to anatomical landmarks for esophageal subsite classification
title_short Endoscopic landmarks corresponding to anatomical landmarks for esophageal subsite classification
title_sort endoscopic landmarks corresponding to anatomical landmarks for esophageal subsite classification
topic classification
endoscopy
esophagus
landmark
pharynx
url https://doi.org/10.1002/deo2.273
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