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01-06-2016 | Thoracic Oncology

Solitary Lymph Node Recurrence of Esophageal Squamous Cell Carcinoma: Surgical Failure or Systemic Disease?

Authors: Tomoki Makino, MD, PhD, Makoto Yamasaki, MD, PhD, Hiroshi Miyata, MD, PhD, Koji Tanaka, MD, PhD, Tsuyoshi Takahashi, MD, PhD, Yukinori Kurokawa, MD, PhD, Kiyokazu Nakajima, MD, PhD, Shuji Takiguchi, MD, PhD, Masaki Mori, MD, PhD, Yuichiro Doki, MD, PhD

Published in: Annals of Surgical Oncology | Issue 6/2016

Abstract

Background

Post-surgical solitary lymph node recurrence (SLNR) may be a characteristic of esophageal squamous cell carcinoma (ESCC).

Methods

Among 402 patients who underwent curative resection for ESCC between 2003 and 2010, we retrospectively reviewed the cases of 148 patients who developed disease recurrence.

Results

Among the 148 reviewed cases, 24 patients (16.2 %) developed SLNR and 124 (83.8 %) developed non-SLNR. Clinicopathological background did not differ between the two groups. Five-year overall survival was 37.8 % among the 22 patients with SLNR who received local treatment (surgery or radiation) with or without systemic chemotherapy, compared with only 2.5 % among patients with non-SLNR (p = 0.0002). Among the 24 cases of SLNR, 18 were localized inside the surgical field (i.e. the standard three-field regional lymph nodes), while six occurred outside of the surgical field (abdominal para-aortic nodes in four cases and mediastinum in two cases). Notably, of the six patients with SLNR outside of the surgical field, four survived without additional recurrence after SLNR development. Among patients with SLNR, survival was not associated with tumor location, tumor size, or time to recurrence. Initial tumor stage was not associated with SLNR incidence but was identified as a predictor of long-term survival among patients with SLNR.

Conclusions

SLNR developed inside and outside of the surgical field, showing a relatively favorable prognosis with local treatment regardless of location. SLNR outside of the surgical field may actually be localized disease in ESCC.

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Title: Solitary Lymph Node Recurrence of Esophageal Squamous Cell Carcinoma: Surgical Failure or Systemic Disease?
Authors: Tomoki Makino, MD, PhD
Makoto Yamasaki, MD, PhD
Hiroshi Miyata, MD, PhD
Koji Tanaka, MD, PhD
Tsuyoshi Takahashi, MD, PhD
Yukinori Kurokawa, MD, PhD
Kiyokazu Nakajima, MD, PhD
Shuji Takiguchi, MD, PhD
Masaki Mori, MD, PhD
Yuichiro Doki, MD, PhD
Publication date: 01-06-2016
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 6/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-015-5086-y

At a glance: The STEP trials

Springer Medicine

Solitary Lymph Node Recurrence of Esophageal Squamous Cell Carcinoma: Surgical Failure or Systemic Disease?

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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