{
  "abstract": "Purpose: Intramural metastasis is defined as the metastatic spread from a primary tumor to the gastrointestinal tract through the intramural lymphatic system. Although several studies have demonstrated the negative impact of intramural metastasis on survival in esophageal cancer, no systematic review including a large number of patients has been conducted yet.\n\nMethods: Reports on esophageal cancer with intramural metastasis from 1990 to 2025 were collected. A pooled analysis was performed using a random-effects model to estimate the hazard ratio for overall survival in patients with intramural metastasis compared with patients without intramural metastasis.\n\nResults: Eleven studies (4494 patients) were included, in whom 315 patients (7.0%) had conventional intramural metastasis, while 57 patients had discontinuous growth. Among these patients, 4162 were diagnosed with esophageal squamous cell carcinoma. Preoperative chemotherapy was administered to 1153 patients (25.7%). The hazard ratio for overall survival was 2.22, with a 95% confidence interval of 1.81–2.72.\n\nConclusions: Our analysis suggests that the adverse prognostic association of IM was observed across different treatment eras and remained evident in studies including patients who received neoadjuvant treatment. Future studies should explore optimal treatment strategies for patients with intramural metastasis.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Gastrointestinal Surgery, Yokohama City University Gastroenterological Center, Yokohama, Kanagawa, Japan",
    "Department of Surgery, Toho University School of Medicine, Tokyo, Japan",
    "Department of Biostatistics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan",
    "Department of Gastroenterological Surgery, Yokohama City University, Yokohama, Kanagawa, Japan"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Sho Sato"
    },
    {
      "affs": [
        1
      ],
      "name": "Hideaki Shimada"
    },
    {
      "affs": [
        2
      ],
      "name": "Yuriko Takeda"
    },
    {
      "affs": [
        3
      ],
      "name": "Itaru Endo"
    },
    {
      "affs": [
        0
      ],
      "name": "Takaki Yoshikawa"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cf9xp3e5ajqad.bib",
  "cited_by": 0,
  "doi": "10.5761/atcs.ra.26-00153",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13711103/",
  "id": "cf9xp3e5ajqad",
  "issns": [
    "1341-1098",
    "2186-1005"
  ],
  "landing_url": "https://doi.org/10.5761/atcs.ra.26-00153",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Review Article"
    ],
    [
      "openalex",
      "2746|Esophageal Cancer Research and Treatment"
    ]
  ],
  "openalex": "W7223303917",
  "pdf_url": "https://www.jstage.jst.go.jp/article/atcs/32/1/32_ra.26-00153/_pdf",
  "pmcid": "PMC13711103",
  "pmid": "42927908",
  "published": "2026-10-24",
  "publisher": "Japanese Editorial Committee of Annals of Thoracic and Cardiovascular Surgery (ATCS)",
  "ris": "https://research.draconitic.com/paper/cf9xp3e5ajqad.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:56Z",
      "native_id": "PMC13711103",
      "source": "pmc",
      "url": "https://doi.org/10.5761/atcs.ra.26-00153"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Esophageal Cancer Research and Treatment",
      "subfield": "surgery"
    }
  ],
  "title": "Systematic Review and Meta-Analysis of Patients with Esophageal Cancer and Intramural Metastasis",
  "title_text": "Systematic Review and Meta-Analysis of Patients with Esophageal Cancer and Intramural Metastasis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:56Z",
  "url": "https://research.draconitic.com/paper/cf9xp3e5ajqad",
  "venue": "Annals of Thoracic and Cardiovascular Surgery",
  "versions": []
}