Mode of Lymphadenectomy and Surgical Outcome of Upper Thoracic Esophageal Squamous Cell Carcinoma

Shimada, Hideaki; Okazumi, S.; Shiratori, Tooru; Akutsu, Yasunori; Matsubara, Hisahiro

doi:10.1007/s11605-008-0790-6

Cited by 8 publications

(11 citation statements)

References 14 publications

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“…An et al [9] classified 217 patients receiving 3-field nodal scavenge into 4 groups, i.e., no LM, having LM in Zone 1, in Zone 2, and in Zone 3, and found that there were signifi cant differences in 5-year survival rate among the patients in the 4 groups. The outcome of the study by Shimada et al [15] was similar to that from An's study. Zhang et al [19] conducted a retrospective analysis of 1,146 EC patients and found that the 5-year survival rates were respectively 59.79%, 33.38%, 14.28%, 6.26% and 2.98% in EC patients with 5 different grades of disease which included the number of the metastasized nodes of 0, 1, 2, 3 and ≥ 4.…”

Section: Discussionsupporting

confidence: 72%

“…Most authors have believed that 3-fi eld scavenge could increase the survival rate of EC patients [13][14][15] . However, Watanabe et al [16] found that the 5-year survival rate of EC patients was higher in the group with the modern 2-fi eld lymphadenectomy than in the other 2 groups, suggesting that the key point of the extended lymphadenectomy is the precise dissection of the lymph nodes surrounding the bilateral RLNs area, instead of a scavenge of the lymph nodes surrounding the neck.…”

Section: Discussionmentioning

confidence: 99%

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Clinical research regarding the ratio of lymph node metastasis and the reasonable extent of lymphadenectomy in middle third thoracic esophageal squamous cell carcinoma

Lin

Zhang

Chen

et al. 2010

Clin. Oncol. Cancer Res.

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OBJECTIVE To explore the extent of lymphadenectomy deemed reasonable by analyzing the infl uence of the regular patt ern and ratio of lymph node metastasis on the prognosis of the patients with middle third thoracic esophageal squamous cell carcinoma. METHODS Clinical data from 129 patients with middle third thoracic esophageal squamous cell carcinoma who underwent curative esophagectomy with modern two-fi eld lymphadenectomy were retrospectively analyzed. RESULTSThe rate of lymphatic metastasis in EC patients was 56.6% in all groups, and the ratio of lymph node metastasis (RLNM, i.e. positive nodes/total dissected nodes) was 11.3%, with a lymphatic metastasis rate of 43.4% in the superior mediastinum. The most commonly involved regions included the sites around the esophagus, the right recurrent laryngeal nerve and the leftsided blood vessels of stomach, as well as the cardia and the inferior tracheal protuberance. The main factors influencing lymphatic metastasis were the depth of tumor infiltration, differentiation of tumor cells and the size of the tumor. The 5-year survival rate for patients in the groups without lymphatic metastasis, with a RLNM ≤ 20%, and a metastasis ratio > 20% was 50.4%, 31.0% and 6.8%, respectively. The differences were statistically signifi cant among the groups (P = 0.000). CONCLUSION The RLNM is one of the key factors affecting the prognosis of EC patients. For conventional therapy for patients with middle third thoracic esophageal carcinoma, modern 2-fi eld lymphadenectomy, including node dissection in the bilateral superior mediastinum, should be performed.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Clinical research regarding the ratio of lymph node metastasis and the reasonable extent of lymphadenectomy in middle third thoracic esophageal squamous cell carcinoma

Lin

Zhang

Chen

et al. 2010

Clin. Oncol. Cancer Res.

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“…It has been shown that the RLN lymph nodes are important in the prediction of metastases to distant lymph nodes during thoracic esophageal cancer. The positivity of RLN lymph nodes for metastases indicates a wider range of lymph node metastases [ 3 , 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Even in cases of unilateral RLN lymph node metastasis, bilateral supraclavicular lymph node dissection should be recommended [ 3 ]. Furthermore, recurrent nerve node metastasis is a possible risk factor for cervical node metastasis [ 4 ]. However, in clinical practice, we found that ultrasounds can be attenuated by air that is present inside the trachea and bronchi and that this limits the use of EUS in the detection of metastases in the para-esophageal lymph nodes, especially in instances of RLN lymph node metastases that are close to the trachea.…”

Section: Introductionmentioning

confidence: 99%

Application of Endobronchial Ultrasonography for the Preoperative Detecting Recurrent Laryngeal Nerve Lymph Node Metastasis of Esophageal Cancer

et al. 2015

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BackgroundThe preoperative detection of recurrent laryngeal nerve lymph node (RLN LN) metastasis provides important information for the treatment of esophageal cancer. We investigated the possibility of applying endobronchial ultrasonography (EBUS) with conventional preoperative endoscopic ultrasonography (EUS) and computerized tomography (CT) examination to evaluate RLN LN metastasis in patients with esophageal cancer.MethodsA total of 115 patients with advanced thoracic esophageal cancer underwent EBUS examinations. Patients also underwent EUS and CT imaging as reference diagnostic methods. Positron emission tomography /computed tomography (PET/CT) was also introduced in partial patients as reference method. The preoperative evaluation of RLN LN metastasis was compared with the surgical and pathological staging in 94 patients who underwent radical surgery.ResultsThe sensitivities of the preoperative evaluations of RLN LN metastasis by EBUS, EUS and CT were 67.6%, 32.4% and 29.4%, respectively. The sensitivity of EBUS was significantly different from that of EUS or CT, especially in the detection of right RLN LNs. In addition, according to the extra data from reference method, PET/CT was not superior to EBUS or EUS in detecting RLN LN metastasis. Among all 115 patients, 21 patients who were diagnosed with tracheal invasions by EUS or EBUS avoided radical surgery. Another 94 patients who were diagnosed as negative for tracheobronchial tree invasion by EUS and EBUS had no positive findings in radical surgery.ConclusionsEBUS can enhance the preoperative sensitivity of the detection of RLN LN metastasis in cases of thoracic esophageal cancer and is a useful complementary examination to conventional preoperative EUS and CT, which can alert thoracic surgeons to the possibility of a greater range of preoperative lymph node dissection. EBUS may also indicate tracheal invasion in cases of esophageal stricture.

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“…In squamous cell carcinoma, patients with cervical esophageal cancer undergo proximal esophagectomy with cervical and upper mediastinal lymphadenectomy using a cervical approach, whereas those with thoracic esophageal cancer undergo total esophagectomy with three-field lymphadenectomy using a transthoracic approach. [6][7][8][9][10] However, there is no agreement on the operative procedure and extent of lymphadenectomy for esophageal squamous cell carcinoma located at the cervicothoracic junction (CT-ESCC). Thus, we retrospectively studied the distribution of metastasis in lymph nodes resected at surgery and the recurrence after surgery for patients with CT-ESCC and investigated the extent of lymphadenectomy that is necessary.…”

mentioning

confidence: 99%

Pattern of Lymphatic Spread of Esophageal Cancer at the Cervicothoracic Junction Based on the Tumor Location

et al. 2015

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Mode of Lymphadenectomy and Surgical Outcome of Upper Thoracic Esophageal Squamous Cell Carcinoma

Abstract: Based on logistic regression analysis, T3/T4 tumors and recurrent nerve node metastasis were possible risk factors for cervical node metastasis.

Cited by 8 publications

References 14 publications

Clinical research regarding the ratio of lymph node metastasis and the reasonable extent of lymphadenectomy in middle third thoracic esophageal squamous cell carcinoma

Clinical research regarding the ratio of lymph node metastasis and the reasonable extent of lymphadenectomy in middle third thoracic esophageal squamous cell carcinoma

Application of Endobronchial Ultrasonography for the Preoperative Detecting Recurrent Laryngeal Nerve Lymph Node Metastasis of Esophageal Cancer

Pattern of Lymphatic Spread of Esophageal Cancer at the Cervicothoracic Junction Based on the Tumor Location

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