Original articleGeneral thoracicSurvival in Patients With Esophageal Adenocarcinoma Undergoing Trimodality Therapy Is Independent of Regional Lymph Node Location
Section snippets
Patients and Methods
This was a multiinstitutional retrospective collaborative study from the Esophageal Cancer Study Group. Three institutions contributed data to the study: MD Anderson Cancer Center (n = 252), University of Rochester Medical Center (n = 30), and Virginia Mason Medical Center (n = 30). The study received approval by the Institutional Review Boards in all participating institutions, and a waiver of patient consent was obtained.
Based on the study’s inclusion criteria, we selected patients with
Results
The final study population consisted of 196 patients (176 men [90%]) with a median age of 61 years (range, 23 to 90 years) and a median body mass index of 27 kg/m2 (range, 18 to 68 kg/m2). Table 1 describes demographic characteristics. The location of 80% of the tumors was at the GEJ, and 72% (141 of 196) of patients presented with clinically involved lymph nodes located in the lesser sac (perigastric/perihepatic) location. However, 11% (22 of 196) of patients had metastatic lymph nodes that
Comment
Our study demonstrates that OS in patients with distal esophageal or GEJ adenocarcinoma treated with multimodality therapy depends on the pathologic depth of tumor invasion (ypT3) and the number of pathologically positive lymph nodes (ypN3) rather than on the specific location of the regional nodal metastases determined on the pretreatment clinical evaluation.
Multimodality therapy, more specifically preoperative chemotherapy or combined chemotherapy with radiotherapy, has become the standard
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