Nodal metastasis and sites of recurrence after en bloc esophagectomy for adenocarcinoma

Clark, Geoffrey W.B.; Peters, Jeffrey H.; Ireland, Adrian P.; Ehsan, Afshin; Hagen, Jeffrey A.; Kiyabu, Milton; Bremner, Cedric G.; DeMeester, Tom R.

doi:10.1016/0003-4975(94)90722-6

Cited by 151 publications

(101 citation statements)

References 15 publications

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“…Abdominal nodal spread in cancer of the cardia has been studied in a number of recent reports which, however, present no analysis of the involvement of the individual abdominal lymph node stations in relation to the pT stage and longitudinal extension of the tumors [18][19][20][21]. Precise knowledge of these data may be very important for the surgeon as a guide in choosing the type of resection and lymphadenectomy.…”

Section: Discussionmentioning

confidence: 99%

Nodal abdominal spread in adenocarcinoma of the cardia. Results of a multicenter prospective study

Manzoni¹,

Morgagni²,

Roviello

et al. 1998

Gastric Cancer

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Section: Discussionmentioning

confidence: 99%

Nodal abdominal spread in adenocarcinoma of the cardia. Results of a multicenter prospective study

Manzoni¹,

Morgagni²,

Roviello

et al. 1998

Gastric Cancer

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“…7 Similarly, Clark et al reported that 19% of patients with esophageal adenocarcinoma developed nodal recurrence in the upper mediastinum. 8 Accordingly, we initiated a prospective observational study in 1994 to evaluate the feasibility and safety of esophagectomy with TFD and to assess the prevalence of metastases to the cervical lymph nodes in our patient population. In a preliminary report on a small number of patients, we observed that unsuspected metastases to the cervical nodes occurred in nearly one third of patients.…”

Section: Discussionmentioning

confidence: 99%

Three-Field Lymph Node Dissection for Squamous Cell and Adenocarcinoma of the Esophagus

et al. 2002

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ObjectiveTo determine the prevalence of occult cervical nodal metastases in patients with squamous cell cancer and adenocarcinoma of the esophagus, and to determine the impact of esophagectomy with three-field lymph node dissection on survival and recurrence rates. Summary Background DataAlthough esophagectomy with three-field lymph node dissection is commonly practiced in Japan, its role in the surgical management of esophageal cancer in the United States, especially in patients with esophageal adenocarcinoma, is essentially unknown. MethodsThis is a prospective observational study of esophagectomy with three-field lymphadenectomy. Eighty patients underwent resection between August 1994 and April 2001. Clinicopathological information and follow-up data were collected on all patients until death or June 2001. ResultsHospital mortality and morbidity rates were 5% and 46%, respectively. Metastases to the recurrent laryngeal and/or deep cervical nodes occurred in 36% of patients irrespective of cell type (adenocarcinoma 37%, squamous 34%) or location within the esophagus (lower third 32%, middle third 60%).Overall 5-year and disease-free survival rates were 51% and 46%, respectively. Sixty-nine percent presented with nodal metastases. The 5-year survival rate for node-negative patients was 88%; that for those with nodal metastases was 33%. The 5-year survival rate in patients with positive cervical nodes was 25% (squamous 40%, adenocarcinoma 15%). ConclusionsEsophagectomy with three-field lymph node dissection can be performed with a low mortality and reasonable morbidity. Unsuspected metastases to the recurrent laryngeal and/or cervical nodes are present in 36% of patients regardless of cell type or location within the esophagus. Thirty percent of patients were upstaged, mainly from stage III to stage IV. An overall 5-year survival rate of 51% suggests a true survival benefit beyond that achieved solely on the basis of stage migration.

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“…Nodal involvement in the neck or abdominal cavity can be found irrespective of primary tumor location [11] and lymph node metastasis is closely related to long-term prognosis in patients who undergo esophagectomy [12]. Intratumoral lymphatic vessel density, and intratumoral and peritumoral lymphatic vessel invasion as predictive factors … In this study, we chose the lymphatic endothelium-specific marker D2-40 to evaluate LVD and LVI because it was found to be specifically expressed in lymphatics, which allows for objective identification [8].…”

Section: Discussionmentioning

confidence: 99%

THORACIC SURGERY Intratumoral lymphatic vessel density, and intratumoral and peritumoral lymphatic vessel invasion as predictive factors of lymph node metastasis and prognostic factors in esophageal cancer

Kozłowski¹,

Niklińska²,

Naumnik³

et al. 2013

kitp

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StreszczeniePrzerzuty do regionalnych węzłów chłonnych w raku przełyku występują wcześnie i są niekorzystnym czynnikiem prognostycznym. Przebadano gęstość naczyń limfatycznych wewnątrz i wokół guza oraz inwazję naczyń limfatycznych wewnątrz i wokół guza metodą immunohistochemiczną w 74 resekowanych guzach raka przełyku, wybarwiając naczynia przeciwciałem D2-40, i skorelowano uzyskane wyniki z cechami kliniczno-patologicznymi i przeżyciem pooperacyjnym chorych. W analizie statystycznej zastosowano testy jedno-i wieloczynnikowej regresji logistycznej, jedno-i wieloczynnikowej analizy przeżycia. Gęstość naczyń limfatycznych wokół guza była znamiennie statystyczne wyższa niż wewnątrz guza (p < 0,001). Gęstość naczyń limfatycznych wokół i wewnątrz guza pozytywnie korelowała z przerzutami do węzłów chłonnych, stopniem zaawansowania, głębokością nacieku nowotworowego i doszczętnością resekcji. Inwazja naczyń limfatycznych wewnątrz i wokół guza pozytywnie korelowały z przerzutami do węzłów chłonnych, wielkością guza, głębokością nacieku nowotworowego, stopniem zaawansowania i doszczętnością resekcji. W analizie wieloczynnikowej regresji logistycznej stwierdzono, że gęstość naczyń limfatycznych wewnątrz guza (p = 0,028) i inwazja komórek nowotworowych w naczyniach limfatycznych wokół guza (p = 0,036) są niezależnymi czynnikami predykcyjnymi ryzyka wystąpienia przerzutów w regionalnych węzłach chłonnych. W modelu wieloczynnikowej regresji Coxa stwierdzono, że inwazja naczyń limfatycznych wewnątrz guza i wokół guza stanowią niezależne czynniki prognostyczne czasu wolnego od nawrotu choroby (p = 0,018, p = 0,021), czasu przeżycia zależnego od choroby (p = 0,016, p = 0,025) i czasu całkowitego przeżycia (p = 0,017, p = 0,02) chorych. Naczynia limfatyczne wewnątrz guza i inwazja naczyń wokół guza są czynnikami predykcyjnymi przerzutów Kardiochirurgia i Torakochirurgia Polska 2013; 10 (2) 120 THORACIC SURGERY AbstractIn esophageal cancer, metastases in regional lymph nodes occur early and are a poor prognostic factor. We studied intratumoral and peritumoral lymphatic vessel density, and intratumoral and peritumoral lymphatic vessel invasion using D2-40 immunohistochemical staining in 74 resected esophageal cancer specimens and correlated results with patients' clinicopathologic features and outcomes. Results were analyzed by univariate and multivariate logistic regression as well as univariate and multivariate survival analysis. The peritumoral lymphatic vessel density was significantly higher than the intratumoral lymphatic vessel density (p < 0.001). The peritumoral lymphatic vessel density and intratumoral lymphatic vessel density positively correlated with lymph node metastasis, tumor stage, depth of tumor invasion, and residual tumor. Positive intratumoral lymphatic vessel invasion and peritumoral lymphatic vessel invasion were significantly correlated with lymph node metastasis, tumor size, tumor depth, stage, and residual tumor. Multivariate logistic regression analysis identified intratumoral lymphatic vessel density (...

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Nodal metastasis and sites of recurrence after en bloc esophagectomy for adenocarcinoma

Cited by 151 publications

References 15 publications

Nodal abdominal spread in adenocarcinoma of the cardia. Results of a multicenter prospective study

Nodal abdominal spread in adenocarcinoma of the cardia. Results of a multicenter prospective study

Three-Field Lymph Node Dissection for Squamous Cell and Adenocarcinoma of the Esophagus

THORACIC SURGERY Intratumoral lymphatic vessel density, and intratumoral and peritumoral lymphatic vessel invasion as predictive factors of lymph node metastasis and prognostic factors in esophageal cancer

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