Skip to main content
Erschienen in: Annals of Surgical Oncology 12/2016

19.07.2016 | Thoracic Oncology

Prognostic Significance of Lymphovascular Invasion for Thoracic Esophageal Squamous Cell Carcinoma

verfasst von: Shaohua Wang, MD, Xiaofeng Chen, MD, Jie Fan, MD, Lu Lu, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 12/2016

Einloggen, um Zugang zu erhalten

Abstract

Objectives

This study was designed to demonstrated the prognostic significance of lymphatic and vascular invasion in thoracic esophageal squamous cell carcinoma after curative surgery and establish their predictive role for lymph node metastasis and recurrence in early-stage disease.

Methods

Clinical data of all patients from 2002 to 2014 who underwent curative surgery for thoracic squamous cell carcinoma were collected from a prospectively maintained database. The association of lymphatic invasion and vascular invasion with clinicopathological variables was illustrated respectively. The effect of lymphatic invasion and vascular invasion on the disease-free survival was determined by Kaplan–Meier analysis stratified by pathological stage. The predictive factors for lymph node metastasis in pT1 tumors and the predictive factors for recurrence in patients without lymph node involvement were analyzed with univariate and multivariate analyses respectively.

Results

Both lymphatic invasion and vascular invasion significantly decreased stage-stratified, disease-free survival (p < 0.001). The independent predictive factors for lymph node metastasis in tumors limited in mucosa and submucosa were: submucosa invasion (p < 0.001, odds ratio [OR] 7.303), lymphatic invasion (p < 0.001, OR 5.031), and tumor differentiation (p = 0.008, OR 1.784). The independent predictive factors for decreased disease-free survival in patients with N0 disease involvement were: lymphatic invasion (p = 0.005, OR 4.326) and deeper tumor invasion (p = 0.001, OR 2.634).

Conclusions

Lymphatic invasion and vascular invasion are negative prognostic factors independent of tumor stage. Lymphatic invasion is a high-risk factor of lymph node metastasis in T1 tumors and a high-risk factor of recurrence in patients without lymph node involvement.
Literatur
1.
Zurück zum Zitat Tanaka T, Matono S, Nagano T, et al. Esophagectomy with extended lymphadenectomy for submucosal esophageal cancer: long-term outcomes and prognostic factors. Ann Surg Oncol. 2011;19:750–6.CrossRefPubMed Tanaka T, Matono S, Nagano T, et al. Esophagectomy with extended lymphadenectomy for submucosal esophageal cancer: long-term outcomes and prognostic factors. Ann Surg Oncol. 2011;19:750–6.CrossRefPubMed
2.
Zurück zum Zitat Kunisaki C, Makino H, Takagawa R, et al. Surgical outcomes in esophageal cancer patients with tumor recurrence after curative esophagectomy. J Gastrointest Surg. 2007;12:802–10.CrossRefPubMed Kunisaki C, Makino H, Takagawa R, et al. Surgical outcomes in esophageal cancer patients with tumor recurrence after curative esophagectomy. J Gastrointest Surg. 2007;12:802–10.CrossRefPubMed
3.
Zurück zum Zitat Zafirellis K, Dolan K, Fountoulakis A, et al. Multivariable analysis of clinical, operative and pathologic features of esophageal cancer: who needs adjuvant therapy? Dis Esophagus. 2002;15:155–9.CrossRefPubMed Zafirellis K, Dolan K, Fountoulakis A, et al. Multivariable analysis of clinical, operative and pathologic features of esophageal cancer: who needs adjuvant therapy? Dis Esophagus. 2002;15:155–9.CrossRefPubMed
4.
Zurück zum Zitat Schoppmann SF, Jesch B, Zacherl J, Riegler MF, Friedrich J, Birner P. Lymphangiogenesis and lymphovascular invasion diminishes prognosis in esophageal cancer. Surgery. 2013;153:526–34.CrossRefPubMed Schoppmann SF, Jesch B, Zacherl J, Riegler MF, Friedrich J, Birner P. Lymphangiogenesis and lymphovascular invasion diminishes prognosis in esophageal cancer. Surgery. 2013;153:526–34.CrossRefPubMed
5.
Zurück zum Zitat Tanaka T, Matona S, Mori N, et al. T1 Squamous cell carcinoma of the esophagus: long-term outcomes and prognostic factors after esophagectomy. Ann Surg Oncol. 2014;21(3):932–8.CrossRefPubMed Tanaka T, Matona S, Mori N, et al. T1 Squamous cell carcinoma of the esophagus: long-term outcomes and prognostic factors after esophagectomy. Ann Surg Oncol. 2014;21(3):932–8.CrossRefPubMed
6.
Zurück zum Zitat Bai B, Ma W, Wang K, et al. Detection of D2–40 monoclonal antibody-labeled lymphatic vessel invasion in esophageal squamous cell carcinoma and its clinicopathologic significance. Cancer Biol Med. 2013;10:81–5.PubMedPubMedCentral Bai B, Ma W, Wang K, et al. Detection of D2–40 monoclonal antibody-labeled lymphatic vessel invasion in esophageal squamous cell carcinoma and its clinicopathologic significance. Cancer Biol Med. 2013;10:81–5.PubMedPubMedCentral
7.
Zurück zum Zitat Waraich N, Rashid F, Jan A, et al. Vascular invasion is not a risk factor in oesophageal cancer recurrence. Int J Surg. 2011; 9:237–40.CrossRefPubMed Waraich N, Rashid F, Jan A, et al. Vascular invasion is not a risk factor in oesophageal cancer recurrence. Int J Surg. 2011; 9:237–40.CrossRefPubMed
8.
Zurück zum Zitat Perry C, Soomro I, Kaye P, et al. Analysis of lymphatic and blood vessel invasion biomarkers in T1 esophagogastric adenocarcinomas for improved patient prognostication. Dis Esophagus. 2015;28(3):262–8.CrossRefPubMed Perry C, Soomro I, Kaye P, et al. Analysis of lymphatic and blood vessel invasion biomarkers in T1 esophagogastric adenocarcinomas for improved patient prognostication. Dis Esophagus. 2015;28(3):262–8.CrossRefPubMed
9.
Zurück zum Zitat Matsubara T, Ueda M, Abe T, et al. Unique distribution patterns of metastatic lymph nodes in patients with superficial carcinoma of the thoracic oesophagus. Br J Surg. 1999;86:669–73.CrossRefPubMed Matsubara T, Ueda M, Abe T, et al. Unique distribution patterns of metastatic lymph nodes in patients with superficial carcinoma of the thoracic oesophagus. Br J Surg. 1999;86:669–73.CrossRefPubMed
10.
Zurück zum Zitat Endo M, Yoshino K, Kawano T, et al. Clinicopathologic analysis of lymph node metastasis in surgically resected superficial cancer of the thoracic esophagus. Dis Esophagus. 2000;13:125–9.CrossRefPubMed Endo M, Yoshino K, Kawano T, et al. Clinicopathologic analysis of lymph node metastasis in surgically resected superficial cancer of the thoracic esophagus. Dis Esophagus. 2000;13:125–9.CrossRefPubMed
11.
Zurück zum Zitat Eguchi T, Nakanishi Y, Shimoda T, et al. Histopathological criteria for additional treatment after endoscopic mucosal resection for esophageal cancer: analysis of 464 surgically resected cases. Mod Pathol. 2006;19:475–80.CrossRefPubMed Eguchi T, Nakanishi Y, Shimoda T, et al. Histopathological criteria for additional treatment after endoscopic mucosal resection for esophageal cancer: analysis of 464 surgically resected cases. Mod Pathol. 2006;19:475–80.CrossRefPubMed
12.
Zurück zum Zitat Araki K, Ohno S, Egashira A, Saeki H, Kawaguchi H, Sugimachi K. Pathologic features of superficial esophageal squamous cell carcinoma with lymph node and distal metastasis. Cancer. 2002;94:570–5.CrossRefPubMed Araki K, Ohno S, Egashira A, Saeki H, Kawaguchi H, Sugimachi K. Pathologic features of superficial esophageal squamous cell carcinoma with lymph node and distal metastasis. Cancer. 2002;94:570–5.CrossRefPubMed
13.
Zurück zum Zitat Fujita H, Sueyoshi S, Yamana H, et al. Optimum treatment strategy for superficial esophageal cancer: endoscopic mucosal resection versus radical esophagectomy. World J Surg. 2001;25:424–31.CrossRefPubMed Fujita H, Sueyoshi S, Yamana H, et al. Optimum treatment strategy for superficial esophageal cancer: endoscopic mucosal resection versus radical esophagectomy. World J Surg. 2001;25:424–31.CrossRefPubMed
14.
Zurück zum Zitat Mitobe J, Ikogami M, Urashima M, et al. Clinicopathological investigation of lymph node metastasis predictors in superficial esophageal squamous cell carcinoma with a focus on evaluation of lympho-vascular invasion. Scand J Gastroenterol. 2013;48(10):1173–82.CrossRefPubMed Mitobe J, Ikogami M, Urashima M, et al. Clinicopathological investigation of lymph node metastasis predictors in superficial esophageal squamous cell carcinoma with a focus on evaluation of lympho-vascular invasion. Scand J Gastroenterol. 2013;48(10):1173–82.CrossRefPubMed
15.
Zurück zum Zitat Ando N, Iizuka T, Ide H, et al. Surgery plus chemotherapy compared with surgery alone for localized squamous cell carcinoma of the thoracic esophagus: a Japan Clinical Oncology Group Study–JCOG9204. J Clin Oncol. 2003;21(24):4592–6.CrossRefPubMed Ando N, Iizuka T, Ide H, et al. Surgery plus chemotherapy compared with surgery alone for localized squamous cell carcinoma of the thoracic esophagus: a Japan Clinical Oncology Group Study–JCOG9204. J Clin Oncol. 2003;21(24):4592–6.CrossRefPubMed
16.
Zurück zum Zitat Lee J, Lee KE, Im YH, et al. Adjuvant chemotherapy with 5-fluorouracil and cisplatin in lymph node-positive thoracic esophageal squamous cell carcinoma. Ann Thorac Surg. 2005;80(4):1170–5.CrossRefPubMed Lee J, Lee KE, Im YH, et al. Adjuvant chemotherapy with 5-fluorouracil and cisplatin in lymph node-positive thoracic esophageal squamous cell carcinoma. Ann Thorac Surg. 2005;80(4):1170–5.CrossRefPubMed
17.
Zurück zum Zitat Shiozaki A, Yamagishi H, Itoi H, et al. Long-term administration of low-dose cisplatin plus 5-fluorouracil prolongs the postoperative survival of patients with esophageal cancer. Oncol Rep 2005;13(4):667–72.PubMed Shiozaki A, Yamagishi H, Itoi H, et al. Long-term administration of low-dose cisplatin plus 5-fluorouracil prolongs the postoperative survival of patients with esophageal cancer. Oncol Rep 2005;13(4):667–72.PubMed
18.
Zurück zum Zitat Huang Q, Luo K, Chen C, et al. Identification and validation of lymphovascular invasion as a prognostic and staging factor in node-negative esophageal squamous cell carcinoma. J Thorac Oncol. 2016;11(4):583–92.CrossRefPubMed Huang Q, Luo K, Chen C, et al. Identification and validation of lymphovascular invasion as a prognostic and staging factor in node-negative esophageal squamous cell carcinoma. J Thorac Oncol. 2016;11(4):583–92.CrossRefPubMed
19.
Zurück zum Zitat Imamura Y, Watanabe M, Nagai Y, et al. Lymphatic vessel invasion detected by the D2-40 monoclonal antibody is an independent prognostic factor in node-negative esophageal squamous cell carcinoma. J Surg Oncol. 2012;105(3):277–83.CrossRefPubMed Imamura Y, Watanabe M, Nagai Y, et al. Lymphatic vessel invasion detected by the D2-40 monoclonal antibody is an independent prognostic factor in node-negative esophageal squamous cell carcinoma. J Surg Oncol. 2012;105(3):277–83.CrossRefPubMed
Metadaten
Titel
Prognostic Significance of Lymphovascular Invasion for Thoracic Esophageal Squamous Cell Carcinoma
verfasst von
Shaohua Wang, MD
Xiaofeng Chen, MD
Jie Fan, MD
Lu Lu, MD
Publikationsdatum
19.07.2016
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 12/2016
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5416-8

Weitere Artikel der Ausgabe 12/2016

Annals of Surgical Oncology 12/2016 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.