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Radiation Oncology
Published in: Radiation Oncology 1/2022

Open Access 01-12-2022 | Metastasis | Research

Postoperative lymphatic recurrence distribution and delineation of the radiation field in lower thoracic squamous cell esophageal carcinomas: a real-world study

Authors: Rongxu Du, Songqing Fan, Xiaobin Wang, Xia Hou, Cheng Zeng, Dan Guo, Rongrong Tian, Dan Yang, Leilei Jiang, Xin Dong, Rong Yu, Huiming Yu, Dongming Li, Shuchai Zhu, Jie Li, Anhui Shi

Published in: Radiation Oncology | Issue 1/2022

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Abstract

Background

To study lymphatic recurrence distribution after radical surgery in the real world and guide clinical tumor volume delineation for regional lymph nodes during postoperative radiotherapy for lower thoracic squamous cell esophageal carcinomas.

Methods

We enrolled patients who underwent radical esophagectomy, without radiation before or after surgery, at 3 cancer hospitals. Patients were classified into groups according to tumor locations. We included patients with tumors in the lower thoracic segment and analyzed the postoperative lymph node recurrence mode. A cutoff value of 10% was used to differentiate high-risk lymph node drainage areas from others.

Results

We enrolled 1905 patients in the whole study series, including 652 thoracic esophageal carcinomas that met our inclusion criteria; there were 241 cases of lower thoracic esophageal carcinomas. 1st, 2nd, 4th, 7th, 8th groups of lymph nodes, according to the 8th edition of the AJCC classification, displayed as high-risk recurrence areas, representing 17.8%, 23.9%, 11.7%, 10.9% and 12.2% of lymph node recurrence. Stage III-IV tumors located in the lower segment of the thoracic esophagus showed a tendency to recur in the left gastric nodes (7.9%) and celiac nodes (10.6%).

Conclusions

According to our results, we recommended including the 4th, 7th and 8th groups of lymph nodes in the radiation field, and for patients with stage III-IV disease, the 17th and 20th groups of nodes should be irradiated during postoperative treatment. Whether including 1st/2nd groups in preventive irradiation needed more proofs.
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Metadata
Title
Postoperative lymphatic recurrence distribution and delineation of the radiation field in lower thoracic squamous cell esophageal carcinomas: a real-world study
Authors
Rongxu Du
Songqing Fan
Xiaobin Wang
Xia Hou
Cheng Zeng
Dan Guo
Rongrong Tian
Dan Yang
Leilei Jiang
Xin Dong
Rong Yu
Huiming Yu
Dongming Li
Shuchai Zhu
Jie Li
Anhui Shi
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2022
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-022-01987-7

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