Prevalence of lymph node metastases in superficial esophageal squamous cell carcinoma

Li, Bin; Chen, Haiquan; Xiang, Jiaqing; Zhang, Yawei; Kong, Yunyi; Garfield, David H.; Li, Hecheng

doi:10.1016/j.jtcvs.2013.07.006

Cited by 72 publications

(77 citation statements)

References 18 publications

(26 reference statements)

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“…non-small cell lung cancer or thyroid cancer [10, 11]. The presence of NSM has also been evaluated in esophageal cancer but its prognostic role is still unclear and requires further investigation [12, 14–18]. Recent studies on this topic are summarized in Table 3.…”

Section: Discussionmentioning

confidence: 99%

“…Such variability could be explained by the different criteria of lymph node classification criteria that were used by the authors. Briefly, NSM has been defined as a) metastatic involvement of distant LNs with peritumoral LNs free of tumor infiltration [12, 16, 18,], b) cervical and/or abdominal involvement but no mediastinal metastasis [14, 15, 19], or c) metastatic infiltration of N2 through N4 lymph nodes but not of N1 nodes according to the Japanese staging system of the Japanese Society for Esophageal Disease [15, 17]. The first definition (metastatic involvement of distant LNs with peritumoral LNs free of tumor infiltration) was used in the present study because we believed it would afford a stricter definition of skip lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

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Nodal skip metastasis in thoracic esophageal squamous cell carcinoma: a cohort study

et al. 2017

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BackgroundNodal skip metastasis is a prognostic factor in some sites of malignancies, but its role in esophageal cancer is still unclear. The present study aimed to investigate occurrence and effect of nodal skip metastases in thoracic esophageal squamous cell carcinoma.MethodsAll 578 patients undergoing esophagectomy for thoracic esophageal squamous cell carcinoma at the Center for Esophageal Diseases located in Padova between January 1992 and December 2010 were retrospectively evaluated. Selection criteria were R0 resection, pathological M0 stage and pathological lymph node involvement. Patients receiving neoadjuvant therapy were excluded.ResultsThe selection identified 88 patients with lymph node involvement confirmed by pathological evaluation. Sixteen patients (18.2%) had nodal skip metastasis. Adjusting for the number of lymph node metastases, patient with nodal skip metastasis had similar 5-year overall survival (14% vs. 13%, p = 0.93) and 5-year disease free survival (14% vs. 9%, p = 0.48) compared to patients with both peritumoral and distant lymph node metastases. The risk difference of nodal skip metastasis was: −24.1% (95% C.I. -43.1% to −5.2%) in patients with more than one lymph node metastasis compared to those with one lymph node metastasis; −2.3% (95% C.I. -29.8% to 25.2%) in middle thoracic esophagus and −23.0% (95% C.I. -47.8% to 1.8%) in lower thoracic esophagus compared to upper thoracic esophagus; 18.1% (95% C.I. 3.2% to 33.0%) in clinical N0 stage vs. clinical N+ stage.ConclusionsNodal skip metastasis is a common pattern of metastatic lymph involvement in thoracic esophageal squamous cell carcinoma. However, neither overall survival nor disease free survival are associated with nodal skip metastasis occurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Nodal skip metastasis in thoracic esophageal squamous cell carcinoma: a cohort study

et al. 2017

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“…This is related to the submucosal lymphatic vessels running longitudinally along the thoracic esophagus, directly draining into the proximal and distal ends and consequently connecting the recurrent nerve and perigastric lymph nodes . Therefore, the locations of lymph node metastasis of SESCC exhibit a unique distribution to the recurrent nerve or perigastric lymph nodes, which can involve a solitary lymph node . The perigastric lymph nodes are also known as frequent metastasis sites, especially for middle and lower thoracic esophageal cancer .…”

Section: Discussionmentioning

confidence: 99%

Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma

et al. 2019

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Background This study evaluated the locations of lymph node recurrence and their association with irradiation fields used for radiotherapy after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma. Methods Medical records of 96 consecutive patients with superficial esophageal squamous cell carcinoma who underwent adjuvant chemoradiotherapy following endoscopic resection were reviewed. Computed tomography was used to identify whether nodal recurrences were within the elective nodal irradiation field. The cumulative incidence of recurrence was calculated, accounting for death as a competing risk. Univariate and multivariate analyses identified factors predicting nodal recurrence. Results The median follow‐up period was 61 months (range: 6‐137 months). Seven patients (7.3%) developed lymph node recurrence only; two patients (2.1%) developed nodal plus local recurrence. Six of the seven cases without local recurrence involved the elective nodal irradiation field, with five cases involving the recurrent nerve lymph nodes. The 5‐year cumulative incidence of lymph node recurrence was higher for T1b tumors with lymphovascular invasion than for T1a tumors with lymphovascular invasion (17.6% vs 6.2%, P = 0.086; HR: 3.74, 95% CI: 0.80‐17.52, P = 0.094) and T1b tumors without lymphovascular invasion (17.6% vs 3.3%, P = 0.031; HR: 6.78, 95% CI: 0.80‐57.63, P = 0.080). Conclusions Lymph node recurrence frequently involved the elective nodal irradiation field, with recurrent nerve lymph nodes being common metastasis sites. The high incidence of nodal recurrence for T1b tumors with lymphovascular invasion highlights a need for new strategies for treating this subset of superficial esophageal squamous cell carcinomas.

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“…Among the mediastinal lymph nodes, those of the right and left recurrent nerves are important targets for lymphadenectomy because metastasis is frequent in these areas (19)(20)(21). In order to create an adequate operating field, we developed slender tracheal forceps.…”

Section: Discussionmentioning

confidence: 99%

Effective Mediastinal Lymphadenectomy for Esophageal Cancer Using Slender Tracheal Forceps in Prone Position Thoracoscopic Esophagectomy

Nakajima

Takahashi

Domeki

et al. 2016

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Prevalence of lymph node metastases in superficial esophageal squamous cell carcinoma

Abstract: Endoscopic treatment can be attempted when the tumor is limited to the lamina propria mucosa. However, 2-field radical lymphadenectomy with careful upper mediastinal lymph node resection should be conducted for submucosal squamous cell carcinoma.

Cited by 72 publications

References 18 publications

Nodal skip metastasis in thoracic esophageal squamous cell carcinoma: a cohort study

Nodal skip metastasis in thoracic esophageal squamous cell carcinoma: a cohort study

Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma

Effective Mediastinal Lymphadenectomy for Esophageal Cancer Using Slender Tracheal Forceps in Prone Position Thoracoscopic Esophagectomy

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