Characteristics of recurrence after radical esophagectomy with two-field lymph node dissection for thoracic esophageal cancer

Li,Cheng-Lin; Zhang,Fu-Li; Wang,Ya-Di; Han,Chun; Sun,Guo-Gui; Liu,Qing; Cheng,Yun-Jie; Jing,Shao-Wu; Yang,Cong-Rong

doi:10.3892/ol.2012.946

January 2013 Volume 5 Issue 1

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January 2013 Volume 5 Issue 1

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Article

Characteristics of recurrence after radical esophagectomy with two-field lymph node dissection for thoracic esophageal cancer

Authors:
- Cheng-Lin Li
- Fu-Li Zhang
- Ya-Di Wang
- Chun Han
- Guo-Gui Sun
- Qing Liu
- Yun-Jie Cheng
- Shao-Wu Jing
- Cong-Rong Yang
View Affiliations / Copyright

Affiliations: Department of Radiation Oncology, Military General Hospital of Beijing PLA, Beijing 100700, P.R. China, Department of Radiation Oncology, Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, P.R. China , Department of Radiation Oncology, The People's Hospital of Tangshan, Tangshan 063001, P.R. China
Pages: 355-359
|
Published online on: October 1, 2012

https://doi.org/10.3892/ol.2012.946
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Abstract

Postoperative radiotherapy has shown positive efficacy in lowering the recurrence rate and improving the survival rate in cases involving lymph node (LN) metastasis. However, the radiotherapy target volume remains controversial. Certain published studies have paid more attention to LNs found to be affected during surgery, while little effort has been made to study the LN metastatic pattern following surgery and its influence on the determination of the target volume of postoperative radiotherapy. In this study, the locoregional recurrence of esophageal squamous cell cancer was examined in 134 patients receiving radical surgery with two-field lymph node dissection from 2004 to 2009. In the 134 cases of recurrence, LN metastasis occurred in 126 patients (94.0%) while 13 patients (9.7%) developed anastomotic recurrence and 5 patients (3.7%) experienced tumor bed recurrence. The difference among the groups was statistically significant (P=0.000). In the 126 cases with lymph node metastasis, the mediastinal metastasis rate (80.2%) was significantly higher compared with the rate of supraclavicular metastasis and abdominal metastasis (P=0.000). A significant difference was identified between right and left supraclavicular LN metastasis (31.7% vs 16.7%, P=0.005). Furthermore, the difference between the metastatic rates in the upper (73.8%), middle (39.7%) and lower mediastinum (1.6%) was statistically significant (P=0.000). Nevertheless, no significant correlation between the rate of LN metastasis was observed in the supraclavicular, mediastinal and abdominal regions for upper, middle and lower thoracic carcinomas (P=0.404, P=0.718 and P=0.169, respectively). Based on our data, LN metastasis is the major locoregional recurrence pattern for esophageal squamous cell cancer following radical surgery. The high-risk lymphatic drainage areas include the supraclavicular nodes, recurrent laryngeal nerve nodes, azygos nodes and subcarinal nodes.

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1	Jemal A, Siegel R, Ward E, et al: Cancer statistics, 2008. CA Cancer J Clin. 58:71–96. 2008. View Article : Google Scholar
2	Tachimori Y and Kato H: Diagnosis and surgery of esophageal cancer. Crit Rev Oncol Hematol. 28:57–71. 1998. View Article : Google Scholar : PubMed/NCBI
3	Xiao ZF, Yang ZY, Miao YJ, et al: Influence of number of metastatic lymph nodes on survival of curative resected thoracic esophageal cancer patients and value of radiotherapy: report of 549 cases. Int J Radiat Oncol Biol Phys. 62:82–90. 2005. View Article : Google Scholar : PubMed/NCBI
4	Chen JQ, Zhu J, Pan JJ, et al: Postoperative radiotherapy improved survival of poor prognostic squamous cell carcinoma esophagus. Ann Thorac Surg. 90:435–442. 2010. View Article : Google Scholar : PubMed/NCBI
5	Chen JQ, Pan JJ, Zheng XW, et al: Number and location of positive nodes, postoperative radiotherapy, and survival after esophagectomy with three-field lymph node dissection for thoracic esophageal squamous cell carcinoma. Int J Radiat Oncol Biol Phys. 2010.Epub ahead of print.
6	Ténière P, Hay J-M, Fingerhut A, et al: Postoperation radiation therapy does not increase survival after curative resection for squamous cell carcinoma of the middle and lower esophagus as shown by a multicenter controlled trial. Surg Gynecol Obstet. 173:123–130. 1991.
7	Nakagawa S, Kanda T, Kosugi S, et al: Recurrence pattern of squamous cell carcinoma of the thoracic esophagus after extended radical esophagectomy with three-field lymphadenectomy. J Am Coll Surg. 198:205–211. 2004. View Article : Google Scholar : PubMed/NCBI
8	Lee SJ, Lee KS, Yim YJ, et al: Recurrence of squamous cell carcinoma of the oesophagus after curative surgery: rates and patterns on imaging studies correlated with tumour location and pathological stage. Clin Radiol. 60:547–554. 2005. View Article : Google Scholar : PubMed/NCBI
9	Li H, Zhang Y, Cai H, et al: Pattern of lymph node metastases in patients with squamous cell carcinoma of the thoracic esophagus who underwent three-field lymphadenectomy. Eur Surg Res. 39:1–6. 2007. View Article : Google Scholar : PubMed/NCBI
10	Cai WJ and Xin PL: Pattern of relapse in surgical treated patients with thoracic esophageal squamous cell carcinoma and its possible impact on target delineation for postoperative radiotherapy. Radiother Oncol. 96:104–107. 2010. View Article : Google Scholar
11	Sobin LH and Wittekind CH: TNM classification of malignant tumors. 6th edition. Wiley Liss; New York: 2002
12	Chapet O, Kong FM, Quint LE, et al: CT-based definition of thoracic lymph node stations: an atlas from the University of Michigan. Int J Radiat Oncol Biol Phys. 63:170–178. 2005. View Article : Google Scholar : PubMed/NCBI
13	Giuli R and Gignoux M: Treatment of carcinoma of the esophagus. Retrospective study of 2,400 patients Ann Surg. 192:44–52. 1980.PubMed/NCBI
14	Ando N, Ozawa S, Kitagawa Y, et al: Improvement in the results of surgical treatment of advanced squamous esophageal carcinoma during 15 consecutive years. Ann Surg. 232:225–232. 2000.PubMed/NCBI
15	Chen G, Wang Z, Liu XY, et al: Recurrence pattern of squamous cell carcinoma in the middle thoracic esophagus after modified Ivor-Lewis esophagectomy. World J Surg. 31:1107–1114. 2007. View Article : Google Scholar : PubMed/NCBI
16	Liu M, Li CY, Zhou DA, et al: The sites of lymph node metastasis in mediastinum after radical surgery for middle thoracic esophagus cancer. Chinese Journal of Radiation Oncology. 2:83–84. 2001.
17	Jang HJ, Lee HS, Kim MS, et al: Patterns of lymph node metastasis and survival for upper esophageal squamous cell carcinoma. Ann Thorac Surg. 92:1091–1098. 2011. View Article : Google Scholar : PubMed/NCBI
18	Akiyama H, Tsunimaru M, Udagawa H, et al: Radical lymph node dissection for cancer of the thoracic esophagus. Ann Surg. 2203:364–372. 1994. View Article : Google Scholar : PubMed/NCBI
19	Shimada Y, Sato F, Maeda M, et al: Validity of intraoperative pathological diagnosis of paratracheal LN as a strategy forselection of patients for cervical lymph node dissection during egophagectomy. Dis Esophagus. 16:246–251. 2003. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Characteristics of recurrence after radical esophagectomy with two-field lymph node dissection for thoracic esophageal cancer

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