Patterns of Failure after the Complete Resection of Thoracic Esophageal Squamous Cell Carcinoma: Implications for Postoperative Radiation Therapy Volumes

Zhang, W.; Wang, Q.; Xiao, Zefen; Zhou, Zongmei; Fen, Q.; Chen, D.; Liang, Jianwei; Hui, Zhouguang; Wang, L.; Yin, Wenwu

doi:10.1016/j.ijrobp.2011.06.513

Cited by 4 publications

(5 citation statements)

References 1 publication

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“…According to previous studies [ 1 – 8 , 14 ], the metastasis rates vary greatly with the site of the cancerous lesion, ranging from 0%–8.3%, 8.1%–13.9%, and 26.8%–40.8% ( P < 0.0001) for the upper, middle, and lower esophageal segments, respectively ( Table 5 ). In this study, we also found the metastasis rates of the upper, middle, and lower esophageal segments to be higher with each segment, indicating increasing incidence for distally located lesions.…”

Section: Discussionmentioning

confidence: 75%

Patterns and rates of abdominal lymphatic metastasis following esophageal carcinoma

et al. 2017

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AimTo determine the rate of abdominal lymph node metastasis after radical surgery for esophageal cancer and define the radiotherapy target area.MethodsOf the 1593 patients who underwent R0 radical esophagectomy for thoracic esophageal squamous cell carcinoma (TE-SCC), 148 developed abdominal lymph node (LN) metastases within three years of surgery. During that time interval, patients were examined by various imaging methods (enhanced computer tomography, magnetic resonance imaging, and positron emission tomography–CT) at set time points. The emerging recurrence pattern, preferred sites for abdominal metastasis, and correlation with added clinical factors were carefully recorded, to permit for delineation of a target area for radiotherapy.ResultsWe found postoperative metastatic abdominal LNs in 9.3% of the patients treated for esophageal cancer. Lesions in the upper, middle, and lower esophageal segments metastasized to abdominal LNs at 2.3%, 7.8%, and 26.6% (P < 0.0001), respectively. Of all cases, 4.8% had fewer than two affected LNs, while 20.1% had more than three metastatic LNs (P< 0.0001). The metastasis rates of negative and positive celiac LNs were 4.6% and 22.7%, respectively. Abdominal LN metastasis rates for the following LNs: 16a2 and 16a1 of para-aortic, celiac artery, posterior surface of the pancreatic head and common hepatic artery were 64.9%, 41.2%, 37.8%, 32.4%, and 20.9%, respectively. The overall rate of metastasis to these groups of LNs was 91.9%.ConclusionThis study determined that stations 16a1 and 16a2 of the para-aortic, truncus coeliacus, posterior surface of the pancreatic head, and arteria hepatica communis lymph nodes were the preferred sites for abdominal LN metastasis, thus defining target areas for postoperative radiotherapy.

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Section: Discussionmentioning

confidence: 75%

Patterns and rates of abdominal lymphatic metastasis following esophageal carcinoma

et al. 2017

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“…The recurrence rates in station 5-10 for all TEC and celiac regions for upper and middle TEC were low, so more evidences should be collected to explain whether these regions should be included in CTV of PRT. Many researches (24,35,36) also suggested that PRT target should include supraclavicular and mediastinal regions for all TEC, while celiac lymph node regions should also be included for lower TEC.…”

Section: ------------------------------------------------------------mentioning

confidence: 99%

A retrospective study of pattern of recurrence after radical surgery for thoracic esophageal carcinoma with or without postoperative radiotherapy

Wang

Zhang

et al. 2018

Oncol Lett

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Abstract. The present study aimed to investigate the recurrence pattern of thoracic esophageal cancer (TEC) following radical surgery for guiding postoperative radiotherapy (PRT). Patterns of recurrence were analyzed in patients with recurrence for the first time after radical surgery at the First Affiliated Hospital of Anhui Medical University (Anhui, China) from January 2012 to December 2015. A total of 244 patients were reviewed in the study. The mean recurrence time for patients with PRT was >1 month longer than that for patients without PRT. The lymphatic, anastomotic and hematological recurrence ratios were 87.9 vs. 69.2%, 4.0 vs. 11.5% and 8.0 vs. 17.2%, respectively for patients without and with PRT. The most common recurrence regions were staion1 and station 2-4 (30.0 vs. 36.5% and 37.2% vs. 23.1%, respectively, for patients without and with PRT). The lymphatic recurrence of upper TEC was almost in station1 and station 2-4 (infield). The middle and lower TEC also had a high probability of lymphatic recurrence in station 1 and station 2-4 (totally 76.3 vs. 57.6% and 61.9 vs. 61.1%, respectively). The recurrence ratio significantly decreased in station 2-4 (infield) for middle TEC patients with PRT compared with patients without PRT (P= 0.03), while no significant differences in the lymphatic recurrence ratios were observed in other regions (P>0.05). The differences of recurrence ratios in station 7, station 8 and celiac regions (infield) for lower TEC patients without and with PRT also demonstrated no statistical significance (P>0.05). The results of the present study indicated that the lower neck, supraclavicular regions and upper mediastinal regions (station 1, 2 and 4) should be included in the clinic target volume (CTV) for PRT, while lower mediastinal regions, celiac regions and anastomotic may not be included in CTV.

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“…Several studies found that postoperative radiotherapy could reduce locoregional recurrence and improve overall survival of ESCC patients, but there is no consensus on the targets for postoperative radiotherapy [7][8][9][10]. Cai and colleagues [17] and Zhang and colleagues [25] suggested that the supraclavicular areas should be included in prophylactic radiotherapy for patients with upper, middle, and lower thoracic EC, but the Radiation Therapy Oncology Group does not recommend irradiation to the supraclavicular areas for patients with middle and lower thoracic EC [26]. Although two-field lymphadenectomy is a main method of lymphadenectomy in EC, it may not provide an accurate assessment of cervical lymph node status.…”

Section: Commentmentioning

confidence: 99%

“…Our results showed that patients with pN2-N3 stage or lower thoracic ESCC had an increased incidence of celiac lymph node recurrence. Cai and associates [17] and Zhang and associates [25] also recommended prophylactic radiation of the celiac lymph nodes for lower thoracic EC patients. However, because of the wide range of target volume of celiac lymph node drainage, radiotherapy may injure organs at risk, such as the gastric remnant, and may subsequently increase radiotherapy-related death.…”

Section: Commentmentioning

confidence: 99%

Patterns of Regional Lymph Node Recurrence After Radical Surgery for Thoracic Esophageal Squamous Cell Carcinoma

Mingming

et al. 2016

The Annals of Thoracic Surgery

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Patterns of Failure after the Complete Resection of Thoracic Esophageal Squamous Cell Carcinoma: Implications for Postoperative Radiation Therapy Volumes

Cited by 4 publications

References 1 publication

Patterns and rates of abdominal lymphatic metastasis following esophageal carcinoma

Patterns and rates of abdominal lymphatic metastasis following esophageal carcinoma

A retrospective study of pattern of recurrence after radical surgery for thoracic esophageal carcinoma with or without postoperative radiotherapy

Patterns of Regional Lymph Node Recurrence After Radical Surgery for Thoracic Esophageal Squamous Cell Carcinoma

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