Skip to main content
main-content

29.10.2018 | Gastrointestinal Oncology | Ausgabe 1/2019

Annals of Surgical Oncology 1/2019

Clinical Impact of the Location of Lymph Node Metastases After Neoadjuvant Chemotherapy for Middle and Lower Thoracic Esophageal Cancer

Zeitschrift:
Annals of Surgical Oncology > Ausgabe 1/2019
Autoren:
MD Hiroshi Miyata, MD Keijirou Sugimura, MD Makoto Yamasaki, MD Tomoki Makino, MD Koji Tanaka, MD Eiichi Morii, MD Takeshi Omori, MD Kazuyoshi Yamamoto, MD Yoshitomo Yanagimoto, MD Masahiko Yano, MD Shinichi Nakatsuka, MD Masaki Mori, MD Yuichiro Doki
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1245/​s10434-018-6946-z) contains supplementary material, which is available to authorized users.

Abstract

Background

In the current cancer staging systems, the location of lymph node (LN) metastases is not considered, although LN status is defined according to the number of LN metastases.

Objectives

This study aimed to investigate the clinical impact of the location of LN metastases in esophageal cancer and to evaluate the relevance of minimizing the extent of lymphadenectomy after neoadjuvant therapy.

Methods

In 561 patients with esophageal cancer who underwent neoadjuvant chemotherapy, the therapeutic value of each LN dissection was estimated by multiplying the incidence of metastasis by the 5-year survival rate of patients with positive nodes. In addition, we examined whether the value was affected by the response to neoadjuvant therapy.

Results

Metastasis to the celiac LN and middle mediastinal LN regions was identified as an independent prognostic factor by multivariate analysis, together with the number of LN metastases; however metastasis to the cervical LN and upper mediastinal LN regions was not identified as an independent prognostic factor. The therapeutic value was high in recurrent nerve LNs, paraesophageal LNs, paracardial LNs, and left gastric LNs. The therapeutic value for each LN dissection did not change according to the response to neoadjuvant therapy, excluding the lower mediastinal LN and perigastric LN stations for which the value was relatively high in patients with a poor response.

Conclusion

The present study shows that the location and number of LN metastases have a prognostic impact in patients with esophageal cancer undergoing neoadjuvant chemotherapy. Limited lymphadenectomy according to the response to neoadjuvant therapy cannot be justified.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de.

Jetzt e.Med zum Sonderpreis bestellen!

Sichern Sie sich jetzt Ihr e.Med-Abo und sparen Sie 50 %!

Weitere Produktempfehlungen anzeigen
Zusatzmaterial
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2019

Annals of Surgical Oncology 1/2019 Zur Ausgabe
  1. Sie können e.Med Chirurgie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

  2. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.