Analysis of the causes of failure after radical surgery in patients with PT3N0M0 thoracic esophageal squamous cell carcinoma and consideration of postoperative radiotherapy

Shen, Wenbin; Gao, Hongmei; Zhu, Shuchai; Li, Youmei; Li, Shuguang; Xu, Jianing

doi:10.1186/s12957-017-1259-4

Cited by 10 publications

(17 citation statements)

References 17 publications

(19 reference statements)

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“…According to our study, the recurrence rates of upper abdominal lymph node vary greatly based on location of ESCC and lower segment ESCC showed more frequently recurrent rates of lymph node, consistent with other previous study [ 1 There was no relationship between clinicopathologic factors and supraclvicular LNs recurrence. In our study, tumor bed recurrence was rarely discovered, probably by reason of tumor bed adjacent to thoracic vertebra and may be confused with middle (No.…”

Section: Disscussionsupporting

confidence: 90%

“…However, the rich lymphatic capillary network in the esophageal mucosa and submucosa facilitate locoregional recurrences after surgery. It has been reported that 25.6-41.8% of patients develop locoregional recurrence [1,2,3]. The suppression of postoperative recurrences will ameliorate the survival of patients with ESCC after curative resection.…”

Section: Introductionmentioning

confidence: 99%

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Pattern of Locoregional Recurrence After Radical Surgery in Patients With Esophageal Squamous Cell Carcinoma and The Design of Target Volume of Postoperative Prophylactic Radiotherapy

Qiu¹,

Jing²,

Jiang³

et al. 2020

Preprint

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Objective The study was undertaken to evaluate preferred sites for locoregional recurrence after radical surgery for patients with esophageal squamous cell carcinoma (ESCC) and to confirm the target volume of postoperative prophylactic radiotherapy.Methods 139 patients with locoregional recurrent ESCC after radical esophagectomy without postoperative radiotherapy were registered in this study. The sites of locoregional recurrence for these patients were collected and influence factors of locoregional recurrence were analyzed.Results The 1, 2, and 3-year progression-free survival rates were 48.2%, 18.0% and 8.6%, respectively. Mediastinum lymph node (LN) recurrence (74.2%) was the most frequent site of recurrence, following the anastomotic site (28.1%), supraclavicular LN (19.4%) and abdominal LN (15.1%) (P=0.000). The upper mediastinum (72.7%) was one of the most common recurrence occurred in mediastinal LN. Compared with upper and middle segment of ESCC, lower segment had the highest recurrence rate of upper abdominal LN (P=0.001). The predictive factors of anastomotic recurrence were the stage of pT3 or pT4, presence of nerve or vessel invasion, removed LN NO.≤ 17, presence of invasion or adhesion and without postoperative adjuvant chemotherapy. In addition, the risk factors of abdominal LN recurrence in patients with middle segment ESCC included the stage of pT3 or pT4, smoking history and without postoperative adjuvant chemotherapy.Conclusion For thoracic ESCC, supraclavicular, upper mediastinum, subcarinal LNs and anastomosis should be incorporated within target volume of postoperative prophylactic radiotherapy. Regarding to lower segment ESCC, target volume should include upper abdominal LNs. And it need cautious evaluated about upper abdominal LNs when presence of clinicopathologic factor in middle segment ESCC.

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Section: Disscussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Pattern of Locoregional Recurrence After Radical Surgery in Patients With Esophageal Squamous Cell Carcinoma and The Design of Target Volume of Postoperative Prophylactic Radiotherapy

Qiu¹,

Jing²,

Jiang³

et al. 2020

Preprint

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“…The staining intensity was scored as 0 (absent), 1 (weak), 2 (moderate), and 3 (strong). The total score was classified into low expression (0-4) and overexpression (5)(6)(7)(8)(9).…”

Section: Immunohistochemistry (Ihc) and Immunohistochemical Score (Ihs)mentioning

confidence: 99%

“…[5][6][7] Lymphatic metastatic recurrence (LMR) is the main reason for treatment failure and poor prognosis. [8][9][10] Even in stage IIA ESCC, the fiveyear survival rate is only 30-50% after complete resection, and many patients may eventually die from LMR. 11 To improve the OS of ESCC patients, it is necessary to control locoregional LMR.…”

Section: Introductionmentioning

confidence: 99%

FOXM1: A potential indicator to predict lymphatic metastatic recurrence in stage IIA esophageal squamous cell carcinoma

et al. 2018

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BackgroundPrevious studies have elucidated that FOXM1 may predict poor prognosis in patients with multiple solid malignant tumors. In this study we explored the differential expression of FOXM1 in stage IIA esophageal squamous cell carcinoma (ESCC) and investigated its prognostic value.MethodsImmunohistochemistry (IHC) and Western blot were used to detect FOXM1 expression in ESCC. Correlations between FOXM1 expression and clinicopathological variables, and five‐year lymphatic metastatic recurrence (LMR) and overall survival (OS) of patients were analyzed.ResultsFOXM1 was aberrantly expressed in ESCC. Statistical analysis revealed a close relationship between FOXM1 expression and tumor size (P = 0.024), depth of invasion (P = 0.048), and degree of differentiation (P = 0.043). The five‐year LMR of patients in the FOXM1 overexpression group was significantly increased compared to the low expression group (P = 0.001). The five‐year OS of patients in the FOXM1 overexpression group was significantly reduced compared to the low expression group (P = 0.007). Log‐rank tests demonstrated that large tumor size (P = 0.044), poor differentiation degree (P = 0.005), deep invasion (P = 0.000), and FOXM1 overexpression (P = 0.007) may indicate poor prognosis in stage IIA ESCC. Cox multivariate regression analysis revealed that all of these variables were independent predictors of unfavorable outcome (P < 0.05).ConclusionFOXM1 could be a predictor of lymphatic metastatic recurrence in stage IIA ESCC after Ivor Lewis esophagectomy.

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“…However, even after radical resection, the 5-year overall survival of ESCC patients with positive lymph nodes is less than 40% [2, 3]. Moreover, the recurrence rate is also high in patients without positive lymph nodes [4]. Thus, accurate and timely detection of minimal residual disease or relapse is crucial for tailoring adjuvant therapy for a longer survival time.…”

Section: Introductionmentioning

confidence: 99%

Targeted sequencing of circulating cell-free DNA in stage II-III resectable oesophageal squamous cell carcinoma patients

et al. 2019

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Background The aim of this study was to investigate the potential of cell-free DNA (cfDNA) as a disease biomarker in oesophageal squamous cell carcinoma (ESCC) that can be used for treatment response evaluation and early detection of tumour recurrence. Methods Matched tumour tissue, pre- and post-surgery plasma and WBCs obtained from 17 ESCC patients were sequenced using a panel of 483 cancer-related genes. Results Somatic mutations were detected in 14 of 17 tumour tissues. Putative harmful mutations were observed in genes involved in well-known cancer-related pathways, including PI3K-Akt/mTOR signalling, Proteoglycans in cancer, FoxO signalling, Jak-STAT signalling, Chemokine signalling and Focal adhesion. Forty-six somatic mutations were found in pre-surgery cfDNA in 8 of 12 patients, with mutant allele frequencies (MAF) ranging from 0.24 to 4.91%. Three of the 8 patients with detectable circulating tumour DNA (ctDNA) had stage IIA disease, whereas the others had stage IIB-IIIB disease. Post-surgery cfDNA somatic mutations were detected in only 2 of 14 patients, with mutant allele frequencies of 0.28 and 0.36%. All other somatic mutations were undetectable in post-surgery cfDNA, even in samples collected within 3–4 h after surgery. Conclusion Our study shows that somatic mutations can be detected in pre-surgery cfDNA in stage IIA to IIIB patients, and at a lower frequency in post-surgery cfDNA. This indicates that cfDNA could potentially be used to monitor disease load, even in low disease-stage patients. Electronic supplementary material The online version of this article (10.1186/s12885-019-6025-2) contains supplementary material, which is available to authorized users.

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Analysis of the causes of failure after radical surgery in patients with PT3N0M0 thoracic esophageal squamous cell carcinoma and consideration of postoperative radiotherapy

Cited by 10 publications

References 17 publications

Pattern of Locoregional Recurrence After Radical Surgery in Patients With Esophageal Squamous Cell Carcinoma and The Design of Target Volume of Postoperative Prophylactic Radiotherapy

Pattern of Locoregional Recurrence After Radical Surgery in Patients With Esophageal Squamous Cell Carcinoma and The Design of Target Volume of Postoperative Prophylactic Radiotherapy

FOXM1: A potential indicator to predict lymphatic metastatic recurrence in stage IIA esophageal squamous cell carcinoma

Targeted sequencing of circulating cell-free DNA in stage II-III resectable oesophageal squamous cell carcinoma patients

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