Initial metastatic, including micrometastatic, sites of lymph nodes in esophageal squamous cell carcinoma

Natsugoe, Shoji; Matsumoto, Masataka; Okumura, Hiroshi; Nakashima, Saburo; Hara, Hiroshi; Uenosono, Yoshikazu; Ehi, Katsuhiko; Ishigami, Sumiya; Takao, Sonshin; Aikou, Takashi

doi:10.1002/jso.20172

Cited by 25 publications

(25 citation statements)

References 15 publications

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“…The sites of lymph node were classified according to the nomenclature and code numbers of the Japanese Society for Esophageal Diseases [9,10] . In the present study, we grouped the dissected lymph nodes into three categories: cervical, thoracic, and abdominal lymph nodes.…”

Section: Lymph Node Classificationmentioning

confidence: 99%

Pattern of Lymph Node Metastases in Patients with Squamous Cell Carcinoma of the Thoracic Esophagus Who Underwent Three-Field Lymphadenectomy

Zhang

Cai

et al. 2006

Eur Surg Res

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Background/Aims: Lymph nodes in patients with squamous cell carcinoma of the thoracic esophagus might be involved with metastases at cervical, mediastinal, and abdominal sites. The range of lymph node dissection is still controversial. The pattern of lymph node metastasis and factors that are correlated with lymph node metastasis affect the surgical procedure of lymph node dissection. The purpose of the present study was to explore the pattern of lymph node metastasis and factors that are correlated with lymph node metastasis in patients with esophageal cancer who underwent three-field lymphadenectomy. Methods: Lymph node metastases in 230 patients who underwent radical esophagectomy with three-field lymphadenectomy were analyzed. The metastatic sites of lymph nodes were correlated with tumor location by chi-square test. Logistic regression was used to analyze clinicopathological factors related to lymph node metastasis. Results:Lymph node metastases were found in 133 of the 230 patients (57.8%). The average number of resected lymph nodes was 25.3 ± 11.4 (range 11–71). The proportions of lymph node metastases were 41.6, 19.44, and 8.3% in neck, thoracic mediastinum, and abdominal cavity, respectively, for patients with upper thoracic esophageal carcinomas, 33.3, 34.7, and 14%, respectively, in those with middle thoracic esophageal carcinomas, and 36.4, 34.1, and 43.2%, respectively, for patients with lower thoracic esophageal carcinomas. We did not observe any significant difference in lymph node metastatic rates among upper, middle, and lower thoracic carcinomas for cervical or thoracic nodes. The difference in lymph node metastatic rates for nodes in the abdominal cavity was significant among upper, middle, and lower thoracic carcinomas. The lower thoracic esophageal cancers were more likely to metastasize to the abdominal cavity than tumors at other thoracic sites. A logistic regression model showed that depth of tumor invasion and lymphatic vessel invasion were factors influencing lymph node metastases. Conclusions: Based on our data, cervical and mediastinal node dissection should be performed independent of the tumor location. Abdominal node dissection should be conducted more vigorously for lower thoracic esophageal cancers than for cancers at other locations. Patients with deeper tumor invasion or lymphatic vessel invasion were more likely to develop lymph node metastases.

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Section: Lymph Node Classificationmentioning

confidence: 99%

Pattern of Lymph Node Metastases in Patients with Squamous Cell Carcinoma of the Thoracic Esophagus Who Underwent Three-Field Lymphadenectomy

Zhang

Cai

et al. 2006

Eur Surg Res

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“…First, past data on the location of lymph node metastasis should be analyzed, particularly for solitary metastases and micrometastases [25]. Because these nodes seem to represent the first node in which primary tumor clinically metastasizes, an understanding of tendencies for the location of first lymph node metastasis can be gained.…”

Section: Future Perspectives For Individual Lymphadenectomy In Superfmentioning

confidence: 99%

Individualization of lymphadenectomy in superficial esophageal squamous cell cancer

et al. 2006

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“…The clinical tumour volume of the first-phase RT included the primary tumour spreading by 3 cm in the craniocaudal direction and involved regional lymph node groups. [23][24][25] According to the lymph node groups defined by Japanese guidelines, 26,27 the neck and upper chest oesophageal SLN irradiation fields cover Group 104, Group 107 and part of Group 108. For lesions involving the middle part of the oesophagus, the radiation field should include Group 104 and Groups 106-108, as well as some part of Group 110.…”

Section: Radiation Therapymentioning

confidence: 99%

Phase I study of concurrent selective lymph node late-course accelerated hyperfractionated radiotherapy and S-1 plus cisplatin for locally advanced oesophageal squamous cell carcinoma

Li¹,

Fu²,

Zhang³

et al. 2016

BJR

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). In the initial five patients, two patients developed DLTs. As MTD was not reached, five additional patients were treated with the same dose level, and DLTs occurred in only one patient. Similar results were found in the last five patients. After CCRT, the objective response rates were 100% for primary tumours and 86.2% for metastatic lymph nodes, respectively. Totally, the observed Grade 3 toxicities during CCRT were leukopenia (20%), neutropenia (20%) and dermatitis (13.3%), and no Grade 4 toxicity occurred. The Kaplan-Meier-estimated overall and progression survival rates were 86.7% and 66.7% (1 year), 73.3% and 60% (2 years) and 73.3% and 60% (3 years). Conclusion:The concurrent SLN LCAF IMRT and chemotherapy with S-1 and CDDP was well tolerated and showed promising efficacy. The dose of S-1 in this regimen was recommended with 80 mg m 22 orally twice daily on Days 1-14 and Days 22-35. Advances in knowledge: CCRT with S-1 plus CDDP exhibited encouraging results with milder toxicities, high objective response rates and ideal overall survival time.

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Initial metastatic, including micrometastatic, sites of lymph nodes in esophageal squamous cell carcinoma

Abstract: Although less invasive surgery, such as reduction of lymphadenectomy, may be suitable for superficial cancer, it should be performed with special care in advanced cancer.

Cited by 25 publications

References 15 publications

Pattern of Lymph Node Metastases in Patients with Squamous Cell Carcinoma of the Thoracic Esophagus Who Underwent Three-Field Lymphadenectomy

Pattern of Lymph Node Metastases in Patients with Squamous Cell Carcinoma of the Thoracic Esophagus Who Underwent Three-Field Lymphadenectomy

Individualization of lymphadenectomy in superficial esophageal squamous cell cancer

Phase I study of concurrent selective lymph node late-course accelerated hyperfractionated radiotherapy and S-1 plus cisplatin for locally advanced oesophageal squamous cell carcinoma

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