Proposed Modification of Nodal Status in AJCC Esophageal Cancer Staging System

18F-FDG PET/CT Has a High Impact on Patient Management and Provides Powerful Prognostic Stratification in the Primary Staging of Esophageal Cancer: A Prospective Study with Mature Survival Data

“…This convergence likely reflects more aggressive treatment allocated to stage IIB-III patients than to patients with less advanced disease, resulting in comparable 5-y survival. Furthermore, the 5-y survival of patients with PET/CT stage IIB-III disease was 38% in our study, which is superior to that previously reported by other groups (9%-34% for stage IIB and 6%-16% for stage III) (1,29,30). It is also substantially superior even when compared with the reported relative survival rate for patients diagnosed with nodal disease in the Surveillance Epidemiology and End Results database (18.4%) (2).…”

Diagnostic performance of diffusion-weighted magnetic resonance imaging in esophageal cancer

“…18 F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) or combined FDG-PET/CT may be of additional value in the detection of distant metastases [6,7]. EUS, CT, and FDG-PET(/CT) are of relatively limited value, however, in the detection of locoregional lymphnode involvement [3][4][5][6][7], whereas the presence and number of lymph-node metastases are important independent predictors for the likelihood of developing systemic disease and long-term survival [3], and the presence of lymph-node metastases may require neoadjuvant chemotherapy or chemoradiotherapy [8]. Furthermore, although EUS combined with fine-needle aspiration (FNA) of suspicious lymph nodes may currently be the most accurate preoperative method for determining nodal status, it is invasive and cannot be performed in the area of the primary tumor because of the risk of tumor seeding [3,9].…”

Chemotherapy followed by surgery in patients with carcinoma of the distal esophagus and celiac lymph node involvement

“…Controversy exists about the implications of positive CLNs. Some clinicians exclude these patients for curative treatment options, whereas others believe that these patients are still eligible for surgery [5][6][7]. Multi-modality treatment has been suggested by some [8][9][10][11][12], but the optimal treatment remains unclear due to the paucity of clinical studies and lack of randomized trials.…”