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01-01-2013

Preoperative Assessment of Tumor Location and Station-Specific Lymph Node Status in Patients with Adenocarcinoma of the Gastroesophageal Junction

Authors: Brechtje A. Grotenhuis, Bas P. L. Wijnhoven, Jan Werner Poley, John J. Hermans, Katharina Biermann, Manon C. W. Spaander, Marco J. Bruno, Hugo W. Tilanus, J. Jan B. van Lanschot

Published in: World Journal of Surgery | Issue 1/2013

Abstract

Background

In esophageal cancer patients preoperative staging will determine the type of surgical procedure and use of neoadjuvant therapy. Tumor location and lymph node status play a pivotal role in this tailored strategy. The aim of the present study was to prospectively evaluate the accuracy of preoperative assessment of tumor location according to the Siewert classification and lymph node status per station with endoscopy/endoscopic ultrasound (EUS) and computed tomography (CT).

Methods

In 50 esophagectomy patients with adenocarcinoma of the gastroesophageal junction (GEJ), tumor location according to Siewert and N-stage per nodal station as determined preoperatively by endoscopy/EUS and CT were compared with the histopathologic findings in the resection specimen.

Results

Overall accuracy in predicting tumor location according to the Siewert classification was 70 % for endoscopy/EUS and 72 % for CT. Preoperative data could not be compared with the pathologic assessment in 11 patients (22 %), as large tumors obscured the landmark of the gastric folds. The overall accuracy for predicting the N-stage in 250 lymph node stations was 66 % for EUS and 68 % for CT. The accuracy was good for those stations located high in the thorax, but poor for celiac trunk nodes.

Conclusions

Given the frequent discrepancy between the endoscopic and pathologic location of the GEJ and the common problem of advanced tumors obscuring the landmarks used in the assessment of the Siewert classification, its usefulness is limited. The overall accuracy for EUS and CT in predicting the N-stage per station was moderate.

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Title: Preoperative Assessment of Tumor Location and Station-Specific Lymph Node Status in Patients with Adenocarcinoma of the Gastroesophageal Junction
Authors: Brechtje A. Grotenhuis
Bas P. L. Wijnhoven
Jan Werner Poley
John J. Hermans
Katharina Biermann
Manon C. W. Spaander
Marco J. Bruno
Hugo W. Tilanus
J. Jan B. van Lanschot
Publication date: 01-01-2013
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 1/2013
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-012-1804-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Preoperative Assessment of Tumor Location and Station-Specific Lymph Node Status in Patients with Adenocarcinoma of the Gastroesophageal Junction

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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