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01-05-2019 | Original Article

Preoperative lymph node status on computed tomography influences the survival of pT1b, T2 and T3 esophageal squamous cell carcinoma

Authors: Kotaro Sugawara, Hiroharu Yamashita, Yukari Uemura, Koichi Yagi, Masato Nishida, Susumu Aikou, Sachiyo Nomura, Yasuyuki Seto

Published in: Surgery Today | Issue 5/2019

Abstract

Purpose

The preoperative lymph node status is critical for tailoring optimal treatments for esophageal squamous cell carcinoma (ESCC). This study aimed to evaluate the prognostic impact of a diagnostic criterion based solely on the short-axis diameters of lymph nodes depicted on computed tomography (CT) in ESCC patients undergoing upfront esophagectomy.

Methods

We retrospectively reviewed 246 pT1b–T3 ESCC patients undergoing upfront esophagectomy. Clinically positive lymph node metastasis (cN+) was defined as nodes with a short-axis diameter of at least 8 mm on CT.

Results

Ninety-three patients had a cN+ status according to this criterion. The overall and recurrence-free survival rates were significantly lower in the cN+ group than in the cN− group (P < 0.001). The overall survival rate was markedly lower in the “pN2/3 and cN+” group than in the other groups (vs. pN0: P < 0.001, vs. pN1: P = 0.002, vs. “pN2/3 and cN−”: P < 0.001). However, the overall survival rate of the “pN2/3 and cN−” group was similar to that of the pN0–1 groups. A multivariate analysis showed that cN+ (P = 0.002), major complications (P = 0.001), and pT3 (P = 0.021) were independently associated with a poor prognosis.

Conclusion

A diagnostic criterion based solely on the short-axis diameters of lymph nodes depicted on CT was useful for stratifying the survival in ESCC patients.

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Title: Preoperative lymph node status on computed tomography influences the survival of pT1b, T2 and T3 esophageal squamous cell carcinoma
Authors: Kotaro Sugawara
Hiroharu Yamashita
Yukari Uemura
Koichi Yagi
Masato Nishida
Susumu Aikou
Sachiyo Nomura
Yasuyuki Seto
Publication date: 01-05-2019
Publisher: Springer Singapore
Published in: Surgery Today / Issue 5/2019
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-018-1741-9

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Springer Medicine

Preoperative lymph node status on computed tomography influences the survival of pT1b, T2 and T3 esophageal squamous cell carcinoma

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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