Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2011

01-10-2011 | Thoracic Oncology

Risk Factors that Influence Early Death Due to Cancer Recurrence After Extended Radical Esophagectomy with Three-Field Lymph Node Dissection

Authors: Shin-ichi Kosugi, MD, PhD, Tatsuo Kanda, MD, PhD, Kazuhito Yajima, MD, PhD, Takashi Ishikawa, MD, PhD, Katsuyoshi Hatakeyama, MD, PhD

Published in: Annals of Surgical Oncology | Issue 10/2011

Login to get access

Abstract

Background

Extended radical esophagectomy with three-field lymph node dissection (3-FLD) has offered significant survival benefit, but some patients still suffer from early recurrence and die within 1 year after surgery. The purpose of this study was to identify the risk factors that influence early death due to cancer recurrence after extended radical esophagectomy with 3-FLD.

Methods

A consecutive series of 276 patients who underwent extended radical esophagectomy with 3-FLD was retrospectively reviewed. Excluding patients who underwent incomplete resection or died of other diseases within 1 year, we compared the clinicopathological characteristics between 203 patients who survived more than 1 year (1-year survival group) and 27 who died of cancer recurrence within 1 year (early-death group) by univariate and multivariate analysis.

Results

Sixty-six patients (32.5%) had recurrent disease in the 1-year survival group. Hematogenous recurrences were more frequent in the early-death group than in the 1-year survival group (41% vs. 26%, respectively, p = 0.0481). There was a significant difference in nodal status, number of metastatic nodes, pathological stage, vessel invasion, and intramural metastasis, and there was borderline significance in the difference of depth of invasion and histological type between the two groups by univariate analysis. Multivariate analysis demonstrated that intramural metastasis was an independent risk factor.

Conclusions

Patients with intramural metastasis have a significant risk of early death even after extended radical esophagectomy with 3-FLD; however, it remains unknown whether surgical intervention can play a significant role for these patients.
Literature
1.
Akiyama H, Tsurumaru M, Udagawa H, Kajiyama Y. Radical lymph node dissection for cancer of the thoracic esophagus. Ann Surg. 1994;220:364–72.PubMedCrossRef
2.
Fujita H, Kakegawa T, Yamana H, et al. Mortality and morbidity rates, postoperative course, quality of life, and prognosis after extended radical lymphadenectomy for esophageal cancer. Comparison of three-field lymphadenectomy with two-field lymphadenectomy. Ann Surg. 1995;222:654–62.PubMedCrossRef
3.
Altorki N, Kent M, Ferrara C, Port J. Three-field lymph node dissection for squamous cell and adenocarcinoma of the esophagus. Ann Surg. 2002;236:177–83.PubMedCrossRef
4.
Sobin LH, Wittekind CH. TNM classification of malignant tumors, 6th edn. New York: Wiley-Liss; 2002.
5.
Kosugi S, Sasamoto R, Kanda T, Matsuki A, Hatakeyama K. Retrospective review of surgery and definitive chemoradiotherapy in patients with squamous cell carcinoma of the thoracic esophagus aged 75 years or older. Jpn J Clin Oncol. 2009;39:360–6.PubMedCrossRef
6.
Nishimaki T, Suzuki T, Suzuki S, Kuwabara S, Hatakeyama K. Outcomes of extended radical esophagectomy for thoracic esophageal cancer. J Am Coll Surg. 1998;186:306–12.PubMedCrossRef
7.
8.
Japan Esophageal Society. Japanese classification of esophageal cancer, 10th edn. Tokyo: Kanehara; 2008.
9.
Igaki H, Kato H, Tachimori Y, Sato H, Daiko H, Nakanishi Y. Prognostic evaluation for squamous cell carcinomas of the lower thoracic esophagus treated with three-field lymph node dissection. Eur J Cardiothorac Surg. 2001;19:887–93.PubMedCrossRef
10.
Nakagawa S, Kanda T, Kosugi S, Ohashi M, Suzuki T, Hatakeyama K. Recurrence pattern of squamous cell carcinoma of the thoracic esophagus after extended radical esophagectomy with three-field lymphadenectomy. J Am Coll Surg. 2004;198:205–11.PubMedCrossRef
11.
Kosugi S, Nishimaki T, Kanda T, Nakagawa S, Ohashi M, Hatakeyama K. Clinical significance of serum carcinoembryonic antigen, carbohydrate antigen 19-9, and squamous cell carcinoma antigen levels in esophageal cancer patients. World J Surg. 2004;28:680–5.PubMedCrossRef
12.
Lagarde SM, de Boer JD, ten Kate FJ, Busch OR, Obertop H, van Lanschot JJ. Postoperative complications after esophagectomy for adenocarcinoma of the esophagus are related to timing of death due to recurrence. Ann Surg. 2008; 247:71–6.PubMedCrossRef
13.
Watanabe M, Kuwano H, Araki K, et al. Prognostic factors in patients with submucosal carcinoma of the oesophagus. Br J Cancer. 2000;83:609–13.PubMedCrossRef
14.
Mal F, Perniceni T, Levard H, Denet C, Validire P, Gayet B. Pre-operative predictive factors of early recurrence after resection of adenocarcinoma of the esophagus and cardia. Gastroenterol Clin Biol. 2005;29:1275–8.PubMedCrossRef
15.
Takubo K, Sasajima K, Yamashita K, Tanaka Y, Fujita K. Prognostic significance of intramural metastasis in patients with esophageal carcinoma. Cancer. 1990;65:1816–9.PubMedCrossRef
16.
Nishimaki T, Suzuki T, Tanaka Y, Aizawa K, Hatakeyama K, Muto T. Intramural metastases from thoracic esophageal cancer: local indicators of advanced disease. World J Surg. 1996;20:32–7.PubMedCrossRef
17.
Hokamura N, Kato H, Tachimori Y, Watanabe H, Yamaguchi H, Nakanishi Y. Preoperative chemotherapy for esophageal carcinoma with intramural metastasis. J Surg Oncol. 2000;75:117–21.PubMedCrossRef
18.
Igaki H, Kato H, Ando N, et al. A randomized trial of postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus neoadjuvant chemotherapy for clinical stage II/III squamous cell carcinoma of the thoracic esophagus (JCOG 9907). ASCO Meeting Abstracts 26:4510.
19.
Kosugi S, Kanda T, Nakagawa S, Ohashi M, Nishimaki T, Hatakeyama K. Efficacy and toxicity of fluorouracil, doxorubicin, and cisplatin/nedaplatin treatment as neoadjuvant chemotherapy for advanced esophageal carcinoma. Scand J Gastroenterol. 2005;40:886–92.PubMedCrossRef
Metadata
Title
Risk Factors that Influence Early Death Due to Cancer Recurrence After Extended Radical Esophagectomy with Three-Field Lymph Node Dissection
Authors
Shin-ichi Kosugi, MD, PhD
Tatsuo Kanda, MD, PhD
Kazuhito Yajima, MD, PhD
Takashi Ishikawa, MD, PhD
Katsuyoshi Hatakeyama, MD, PhD
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1712-5

Other articles of this Issue 10/2011

Annals of Surgical Oncology 10/2011 Go to the issue

Gastrointestinal Oncology

COX2 Expression Predicts Resistance to Chemoradiotherapy in Esophageal Squamous Cell Carcinoma

Hepatobiliary Tumors

Clinical Scoring Systems for Stratifying Risk after Resection of Hepatic Colorectal Metastases: Still Relevant?

Urologic Oncology

Radical Prostatectomy Versus External-Beam Radiotherapy for Localized Prostate Cancer: Long-Term Effect on Biochemical Control—In Search of the Optimal Treatment

Breast Oncology

Identifying Gaps in the Locoregional Management of Early Breast Cancer: Highlights from the Kyoto Consensus Conference

Endocrine Tumors

Adrenalectomy: Is Volume a Surrogate for Quality?

Neuro-Oncology

Prognostic Impact of CD133 mRNA Expression in 48 Glioblastoma Patients Treated with Concomitant Radiochemotherapy: A Prospective Patient Cohort at a Single Institution