Journal ArticleDOI
Lymph node retrieval during esophagectomy with and without neoadjuvant chemoradiotherapy: prognostic and therapeutic impact on survival.
A. Koen Talsma,Joel Shapiro,Caspar W. N. Looman,Pieter van Hagen,Ewout W. Steyerberg,Ate van der Gaast,Mark I. van Berge Henegouwen,Bas P. L. Wijnhoven,J. Jan B. van Lanschot +8 more
TLDR
The number of resected nodes had a prognostic impact on survival in patients after surgery alone, but its therapeutic value is still controversial, and data question the indication for maximization of lymphadenectomy after nCRT.Abstract:
OBJECTIVES: We aimed to examine the association between total number of resected nodes and survival in patients after esophagectomy with and without nCRT. BACKGROUND: Most studies concerning the potentially positive effect of extended lymphadenectomy on survival have been performed in patients who underwent surgery alone. As nCRT is known to frequently "sterilize" regional nodes, it is unclear whether extended lymphadenectomy after nCRT is still useful. METHODS: Patients from the randomized CROSS-trial who completed the entire protocol (ie, surgery alone or chemoradiotherapy + surgery) were included. With Cox regression models, we compared the impact of number of resected nodes as well as resected positive nodes on survival in both groups. RESULTS: One hundred sixty-one patients underwent surgery alone, and 159 patients received multimodality treatment. The median (interquartile range) number of resected nodes was 18 (12-27) and 14 (9-21), with 2 (1-6) and 0 (0-1) resected positive nodes, respectively. Persistent lymph node positivity after nCRT had a greater negative prognostic impact on survival as compared with lymph node positivity after surgery alone. The total number of resected nodes was significantly associated with survival for patients in the surgery-alone arm (hazard ratio per 10 additionally resected nodes, 0.76; P=0.007), but not in the multimodality arm (hazard ratio 1.00; P=0.98). CONCLUSIONS: The number of resected nodes had a prognostic impact on survival in patients after surgery alone, but its therapeutic value is still controversial. After nCRT, the number of resected nodes was not associated with survival. These data question the indication for maximization of lymphadenectomy after nCRT.read more
Citations
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8th edition AJCC/UICC staging of cancers of the esophagus and esophagogastric junction: application to clinical practice
TL;DR: The 8th edition of the American Joint Committee on Cancer (AJCC) staging of epithelial cancers of the esophagus and esophagogastric junction presents separate classifications for clinical, pathologic, and postneoadjuvant stage groups, with the role of ypTNM classification in additional treatment decision-making currently limited.
Journal ArticleDOI
Cancer of the esophagus and esophagogastric junction-Major changes in the American Joint Committee on Cancer eighth edition cancer staging manual.
Thomas W. Rice,Donna M. Gress,Deepa T. Patil,Wayne L. Hofstetter,David P. Kelsen,Eugene H. Blackstone +5 more
TL;DR: The American Joint Committee on Cancer (AJCC) Cancer Staging Manual for epithelial cancers of the esophagus and esophagogastric junction are separate, temporally related cancer classifications as mentioned in this paper.
Journal ArticleDOI
Prognostic Value of Lymph Node Yield on Overall Survival in Esophageal Cancer Patients: A Systematic Review and Meta-analysis.
TL;DR: In this article, a meta-analysis determined whether increased lymph node yield improves survival in patients with esophageal cancer undergoing esophagectomy with or without neoadjuvant therapy.
Journal ArticleDOI
Impact of Lymph Node Yield on Overall Survival in Patients Treated With Neoadjuvant Chemoradiotherapy Followed by Esophagectomy for Cancer: A Population-based Cohort Study in the Netherlands
TL;DR: This large population-based cohort study demonstrates an association between LNY and overall survival, indicating a therapeutic value of extended lymphadenectomy during esophagectomy, and should be the standard of care after nCRT.
Journal ArticleDOI
Multimodality treatment for esophageal adenocarcinoma: multi-center propensity-score matched study
Sheraz R. Markar,Bo Jan Noordman,Hugh Mackenzie,John M. Findlay,Piers R. Boshier,Melody Ni,Ewout W. Steyerberg,A. van der Gaast,Maarten C.C.M. Hulshof,Nick Maynard,M. I. van Berge Henegouwen,B. P. L. Wijnhoven,John V. Reynolds,J. J. B. van Lanschot,George B. Hanna +14 more
TL;DR: The survival differences between NCRS and NCS maybe modest, if present at all, for the treatment of locally advanced esophageal or junctional adenocarcinoma, from this large multi-center European study.
References
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Journal ArticleDOI
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Jan B F Hulscher,Johanna W. van Sandick,Angela G. E. M. de Boer,Bas P. L. Wijnhoven,Jan G.P. Tijssen,Paul Fockens,Peep F. M. Stalmeier,Fiebo J.W. ten Kate,Herman van Dekken,Huug Obertop,Hugo W. Tilanus,J. Jan B. van Lanschot +11 more
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The Will Rogers phenomenon. Stage migration and new diagnostic techniques as a source of misleading statistics for survival in cancer.
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Journal ArticleDOI
The Number of Lymph Nodes Removed Predicts Survival in Esophageal Cancer: An International Study on the Impact of Extent of Surgical Resection
Christian G. Peyre,Jeffrey A. Hagen,Steven R. DeMeester,Nasser K. Altorki,Ermanno Ancona,S. Michael Griffin,Arnulf H. Hölscher,Toni Lerut,Simon Law,Thomas W. Rice,Alberto Ruol,J. Jan B. van Lanschot,John Wong,Tom R. DeMeester +13 more
TL;DR: The number of lymph nodes removed is an independent predictor of survival after esophagectomy for cancer, and to maximize this survival benefit a minimum of 23 regional lymph nodes must be removed.
Journal ArticleDOI
Posttherapy pathologic stage predicts survival in patients with esophageal carcinoma receiving preoperative chemoradiation
Lucian R. Chirieac,Stephen G. Swisher,Jaffer A. Ajani,Ritsuko Komaki,Arlene M. Correa,Jeffrey S. Morris,Jack A. Roth,Asif Rashid,Stanley R. Hamilton,Tsung-Teh Wu M.D. +9 more
TL;DR: In patients with locoregional carcinoma of the esophagus or esophagogastric junction who underwent preoperative chemoradiation, it is unclear whether survival was better predicted by pretherapy clinical stage or by posttherapy pathologic stage.
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