Preoperative Chemoradiation Therapy Decreases the Number of Lymph Nodes Resected During Esophagectomy

Issaka, Adamu; Ermerak, Nezih Onur; Bilgi, Zeynep; Kara, H. Volkan; Çelikel, Çiğdem; Batırel, Hasan Fevzi

doi:10.1007/s00268-014-2847-x

Cited by 12 publications

(8 citation statements)

References 30 publications

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“…Several studies have shown that neoadjuvant treatment results in a reduced number of resected lymph nodes, whereas others have reported a lower number of metastatic lymph nodes but no reduction in the total number of lymph nodes. The introduction of neoadjuvant treatment since 2010 in the present study may have led to some distortion in the assessment of total number of lymph nodes as an QOC indicator.…”

Section: Discussionmentioning

confidence: 56%

Changes in treatment and outcome of oesophageal cancer in Denmark between 2004 and 2013

Kjær

Larsson

Svendsen

et al. 2017

British Journal of Surgery

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Section: Discussionmentioning

confidence: 56%

Changes in treatment and outcome of oesophageal cancer in Denmark between 2004 and 2013

Kjær

Larsson

Svendsen

et al. 2017

British Journal of Surgery

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“…Besides, it was reported that neoadjuvant therapy significantly decreased the total number of lymph nodes retrieved in rectal cancer 28,29 . Issaka et al 30 also found that preoperative chemoradiation caused a significant reduction in the number of retrieved lymph nodes during esophagectomy. To assess nodal staging accurately, the NCCN guidelines have proposed at least 15 lymph nodes be dissected in patients undergoing esophagectomy with neoadjuvant treatment 31 .…”

Section: Discussionmentioning

confidence: 96%

Log odds of positive lymph nodes predicts survival in patients treated with neoadjuvant therapy followed by esophagectomy

Chen

Wang

et al. 2020

Journal of Surgical Oncology

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Background and Objectives: We aimed to evaluate the efficacy of the log odds of positive lymph nodes (LODDS) in survival prediction of patients with esophageal carcinoma receiving neoadjuvant therapy, compared with N descriptor and positive lymph node ratio (LNR). Methods: Patients with esophageal carcinoma receiving neoadjuvant therapy from 2004 to 2015 were reviewed in Surveillance, Epidemiology, and End Results database. The receiver operating characteristics curve and area under the curve (AUC) were used to compare discriminatory power among N descriptor, LNR, and LODDS. The goodness of fit was measured using the −2 log-likelihood ratio (-2LLR). Results: About 2239 patients with a 22 months median follow-up and a 37.8% 5-year overall survival rate were included. LODDS had the best discriminatory power and goodness of fit (LODDS vs N descriptor, AUC 0.666 vs 0.626, −2LLR 15 680.402 vs 15 746.162; LODDS vs LNR, AUC 0.666 vs 0.635, −2LLR 15 680.402 vs 15 712.379; all P < .001). LODDS was the best for fewer than 15 lymph nodes retrieved (LODDS vs N descriptor, AUC 0.652 vs 0.618, P < .001; LODDS vs LNR, AUC 0.652 vs 0.625, P = .005). The prognosis of patients without metastatic nodes could be discriminated by LODDS. Conclusions: LODDS could better predict survival of patients with esophageal carcinoma receiving neoadjuvant therapy. K E Y W O R D S esophageal carcinoma, log odds of positive lymph nodes, neoadjuvant therapy

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“…Our study identified that preoperative RT is a significant factor in decreasing nodal count of NDs in patients with HNCs. The impact that preoperative RT has on lymph node count has been reported extensively in colorectal cancer and esophageal cancer . Because it has been well established that RT decreases lymph node count in other anatomical regions, a similar trend can be extrapolated and expected in HNCs.…”

Section: Discussionmentioning

confidence: 73%

Impact of Radiotherapy on Neck Dissection Nodal Count in Patients With Head and Neck Cancer

Sultana

Rangabashyam

et al. 2020

The Laryngoscope

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Objectives/Hypothesis Our study aimed to review the impact of preoperative radiotherapy (RT) and other factors on the lymph node count of neck dissection (ND) specimens from patients with head and neck cancer (HNC). A retrospective study was conducted on all patients with head and neck cancers who had undergone NDs in Singapore General Hospital between 1992 and 2013. Study Design Retrospective study. Methods Patients were categorized into two groups: patients treated with RT with or without chemotherapy before ND and patients who had undergone ND surgery without previous history of RT. The primary endpoint for this study would be the lymph node count from ND. Results The study cohort consists of 1,024 NDs on 829 patients. There were 597 (58.3%) radical/modified radical NDs involving levels I–V. Within this group, 75 (12.6%) NDs had preoperative RT. Preoperative RT and age were found to significantly reduce nodal yield in both univariate and multivariate analysis in the radical/modified radical ND subgroup. In our multivariate analysis, preoperative RT was shown to decrease the nodal yield by 7.464 (P = .0002, 95% confidence interval [CI]: −11.35 to −3.58). Advanced age independently decreases nodal yield, even after accounting for the effect of RT (P = .0002, 95% CI: −0.27 to −0.08). In addition, preoperative RT has a more pronounced effect in reducing lymph node count in the older age group. Conclusions Preoperative RT and advanced age are independent and synergistic factors that reduce nodal count from NDs in patients with head and neck cancers. Level of Evidence 4 Laryngoscope, 130: 1947–1953, 2020

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Preoperative Chemoradiation Therapy Decreases the Number of Lymph Nodes Resected During Esophagectomy

Cited by 12 publications

References 30 publications

Changes in treatment and outcome of oesophageal cancer in Denmark between 2004 and 2013

Changes in treatment and outcome of oesophageal cancer in Denmark between 2004 and 2013

Log odds of positive lymph nodes predicts survival in patients treated with neoadjuvant therapy followed by esophagectomy

Impact of Radiotherapy on Neck Dissection Nodal Count in Patients With Head and Neck Cancer

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