Salvage Lymphadenectomy of the Right Recurrent Nerve Node with Tracheal Involvement After Definitive Chemoradiation Therapy for Esophageal Squamous Cell Carcinoma: Report of Two Cases

Doki, Yuichiro; Yasuda, Takushi; Miyata, Hiroshi; Fujiwara, Yoshiyuki; Takiguchi, Shuji; Yamasaki, Makoto; Makari, Yoichi; Matsuyama, Jin; Masuoka, Takeshi; Monden, Morito

doi:10.1007/s00595-006-3447-7

Cited by 13 publications

(12 citation statements)

References 16 publications

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“…There were 64 individual case reports and 96 case series (consisting of more than one case). Of the 96 case series, 17 series contained enough details to extract individual patient data; these 110 patients were analyzed with the individual case reports (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Forty-five case series reported exclusively on tracheal invasion by thyroid cancer (Table S1).…”

Section: Quantity Of Evidencementioning

confidence: 99%

“…Two series of aerodigestive tract invasion by thyroid cancer reported patients who underwent partial to circumferential tracheal and esophageal resections, but did not specify how many patients had concomitant resections (33,36). There was one patient with esophageal cancer who underwent tangential tracheal resection, spiral tracheoplasty and esophagectomy (19) and two patients with esophageal cancer who underwent partial esophagectomy with partial tracheal resection and muscle flap reconstruction (15).…”

Section: Assessment Of Treatmentmentioning

confidence: 99%

“…Data on recurrence were extracted from 13 case series identified for collective analysis (7,17,27,29,33,35,73,124,126,(135)(136)(137)(138)) and nine individual case reports (14,15,17,44,56,61,81,98,139) and are listed in Table S4. The disease-free interval ranged from 1 to 58 months.…”

Section: Assessment Of Recurrencementioning

confidence: 99%

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Secondary tracheal tumors: a systematic review

Madariaga¹,

Gaissert²

2018

Ann. Cardiothorac. Surg.

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Background: Secondary tracheal tumors arise from mural invasion by primary tumors in adjacent organs, metastatic lymph nodes or blood-born metastasis from distant sites. This systematic review aims to assess the presentation, management options, and clinical outcomes of these uncommon non-tracheal malignancies.Methods: Electronic searches of the MEDLINE database were performed to identify case series and individual case reports of tracheal invasion by primary non-tracheal tumors or metastatic disease. AllEnglish-language studies with available abstracts or articles containing primary data were included.Results: From 1978 to 2017, a total of 160 case reports or case series identified 2,242 patients with invasion of the trachea by tumors of adjacent organs (n=1,853) or by metastatic lymph nodes or hematogenous spread (n=389). Common primary sites of origin were thyroid, esophagus, and lung, and the most common presentation was metachronous (range of interval: 0 to 564 months) with dyspnea, neck mass, voice change and/or hemoptysis. A majority of patients in case reports (77.9%) and case series (66.0%) underwent resection and the most common reported operation was segmental tracheal resection. Fewer patients underwent bronchoscopic intervention (21.7%) and radiation was used in 32.2% of patients. Complications after bronchoscopic treatment included bleeding, granulation tissue, and retained secretions, while anastomotic leak, unplanned tracheostomy, and new recurrent laryngeal nerve paralysis were observed after surgical resection. The rate of 30-day mortality was low (0.01-1.80%). Median survival was higher in patients with thyroid malignancy and in patients who underwent surgical management. Follow-up time ranged from 0.03 to 183 months. Conclusions:Patients with tracheal invasion by metastatic or primary non-tracheal malignancies should be assessed for symptoms, tumor grade, tumor recurrence and concurrent metastases to decide on optimal surgical, bronchoscopic or noninterventional therapy. Clinical experience suggests that palliative endoscopic intervention for tracheal obstruction by metastasis-bearing lymph nodes is underreported.Keywords: Endotracheal metastasis; secondary tracheal tumors; systematic review Submitted Nov 24, 2017. Accepted for publication Dec 21, 2017Dec 21, . doi: 10.21037/acs.2018 View this article at: http://dx.doi.org/10.21037/acs.2018.02.01 Systematic Review IntroductionSecondary tracheal tumors are defined as tumors in, but not of the trachea and comprise a wide spectrum of tumor histologies and stages. There are no populationbased data for these tumors, and in clinical practice these lesions are probably more common than primary neoplasms. A thoracic surgeon probably encounters tracheal obstruction by metastatic lymph nodes more often than invasion by adjacent primary tumors. Since natural history and prognosis are related to the tumor of origin, their management and prognosis may differ considerably from primary tracheal neoplasms; a correct diagnosis with attribution to the origi...

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Section: Quantity Of Evidencementioning

confidence: 99%

Section: Assessment Of Treatmentmentioning

confidence: 99%

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Secondary tracheal tumors: a systematic review

Madariaga¹,

Gaissert²

2018

Ann. Cardiothorac. Surg.

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“…Although a wide variety of procedures of salvage surgery for lymph node metastasis after dCRT have been implemented, depending on the extent and the location of recurrent and/or metastatic foci [13,[20][21][22], no defi nitive rule of surgical procedure or approach has been established. In the present case, because the lymph node metastasis was limited to the cervical portion after dCRT, the cervical approach for the cervical lymph nodes was selected.…”

Section: Discussionmentioning

confidence: 99%

Lymph node dissection with cervical approach as a salvage surgery for locoregional failure after definitive chemoradiotherapy in a patient with recurrent esophageal carcinoma: report of a case

et al. 2009

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Lymph node dissection with cervical approach as a salvage surgery for locoregional failure after defi nitive chemoradiotherapy in a patient with recurrent esophageal carcinoma: report of a case Abstract Salvage surgery is one important therapeutic option after locoregional failure of defi nitive chemoradiotherapy (dCRT) in patients with advanced or recurrent esophageal carcinoma. We have performed cervical lymph node dissection as a salvage surgery after chemoradiotherapy in a patient with recurrent esophageal carcinoma. A 54-year-old Japanese man was admitted to our hospital because of multiple lymph node metastases after endoscopic submucosal dissection (ESD) for early-stage esophageal carcinoma. The patient underwent a circumferential ESD of early-stage esophageal carcinoma in another hospital. The esophageal carcinoma, measuring 75 × 60 mm in size, was a superfi cial spreading type located in the middle portion of the thoracic esophagus. Histology of the resected specimen revealed a moderately to poorly differentiated squamous cell carcinoma, and the depth of invasion was limited within the mucosal layer associated with a small area being attached to the muscularis mucosae. Five months after ESD, lymph node metastases in the regions of right recurrent nerve and the left tracheobronchus were found, for which dCRT was performed. These metastatic lymph nodes disappeared in the chest CT scan images. Lymph node metastasis in the region of the right recurrent nerve then reappeared 8 months after the completion of CRT. Considering the solitary lymph node metastasis and surgical invasiveness, lymph node dissection using a cervical approach was selected as a salvage surgery. Cervical approach for the lymph node dissection in the region of right recurrent nerve may be one feasible option as a minimally invasive salvage surgery for patients with recurrent esophageal carcinoma after dCRT.

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“…1,2 However, embryological events during primary aortic arch morphogenesis can result in anatomical variations. 3,4 Situs inversus totalis is one such unusual disorder, in which the organs are arranged in a mirror image of their normal positions.…”

Section: Introductionmentioning

confidence: 99%

Esophagectomy via left thoracotomy for esophageal cancer with situs inversus totalis: Report of a case

et al. 2008

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We report a case of successful esophagectomy via a left thoracotomy for esophageal cancer in a 57-year-old Japanese man with situs inversus totalis. An upper gastrointestinal endoscopy, performed to investigate the cause of dysphagia, revealed a 7-cm irregular shaped mass occupying more than half of the circumference of the middle-third of the esophagus. Computed tomography (CT) showed enlarged mediastinal lymph nodes and situs inversus totalis. Histological examination of a biopsy specimen revealed squamous cell carcinoma of the esophagus. Although esophagectomy is usually performed through a right thoracotomy because of the left position of the aortic arch, we performed successful subtotal esophagectomy with radical lymph node dissection through a left thoracotomy. During surgery, we modifi ed the standard surgical technique in a mirrorimage fashion to complete the esophagectomy safely. The patient had an uneventful postoperative course.

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Salvage Lymphadenectomy of the Right Recurrent Nerve Node with Tracheal Involvement After Definitive Chemoradiation Therapy for Esophageal Squamous Cell Carcinoma: Report of Two Cases

Cited by 13 publications

References 16 publications

Secondary tracheal tumors: a systematic review

Secondary tracheal tumors: a systematic review

Lymph node dissection with cervical approach as a salvage surgery for locoregional failure after definitive chemoradiotherapy in a patient with recurrent esophageal carcinoma: report of a case

Esophagectomy via left thoracotomy for esophageal cancer with situs inversus totalis: Report of a case

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