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Lagarde SM, Anderegg MCJ, Gisbertz SS, et al. Lymph node metastases near the celiac trunk should be considered separately from other nodal metastases in patients with cancer of the esophagus or gastroesophageal junction after neoadjuvant treatment and surgery. J Thorac Dis. 2018;10(3):1511-1521doi: 10.21037/jtd.2018.02.81.
Lagarde, S. M., Anderegg, M. C. J., Gisbertz, S. S., Meijer, S. L., Hulshof, M. C. C. M., Bergman, J. J. G. H. M., van Laarhoven, H. W. M., & van Berge Henegouwen, M. I. (2018). Lymph node metastases near the celiac trunk should be considered separately from other nodal metastases in patients with cancer of the esophagus or gastroesophageal junction after neoadjuvant treatment and surgery. Journal of thoracic disease, 10(3), 1511-1521. https://doi.org/10.21037/jtd.2018.02.81
Lagarde, Sjoerd M, et al. "Lymph node metastases near the celiac trunk should be considered separately from other nodal metastases in patients with cancer of the esophagus or gastroesophageal junction after neoadjuvant treatment and surgery." Journal of thoracic disease vol. 10,3 (2018): 1511-1521. doi: https://doi.org/10.21037/jtd.2018.02.81
Lagarde SM, Anderegg MCJ, Gisbertz SS, Meijer SL, Hulshof MCCM, Bergman JJGHM, van Laarhoven HWM, van Berge Henegouwen MI. Lymph node metastases near the celiac trunk should be considered separately from other nodal metastases in patients with cancer of the esophagus or gastroesophageal junction after neoadjuvant treatment and surgery. J Thorac Dis. 2018 Mar;10(3):1511-1521. doi: 10.21037/jtd.2018.02.81. PMID: 29707301; PMCID: PMC5906332.
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J Thorac Dis. 2018 Mar;10(3):1511-1521. doi: 10.21037/jtd.2018.02.81.

Lymph node metastases near the celiac trunk should be considered separately from other nodal metastases in patients with cancer of the esophagus or gastroesophageal junction after neoadjuvant treatment and surgery.

Journal of thoracic disease

Sjoerd M Lagarde, Martinus C J Anderegg, Suzanne S Gisbertz, Sybren L Meijer, Maarten C C M Hulshof, Jacques J G H M Bergman, Hanneke W M van Laarhoven, Mark I van Berge Henegouwen

Affiliations

  1. Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands.
  2. Department of Pathology, Academic Medical Center, Amsterdam, the Netherlands.
  3. Department of Radiotherapy, Academic Medical Center, Amsterdam, the Netherlands.
  4. Department of Gastroenterology, Academic Medical Center, Amsterdam, the Netherlands.
  5. Department of Medical Oncology, Academic Medical Center, Amsterdam, the Netherlands.

PMID: 29707301 PMCID: PMC5906332 DOI: 10.21037/jtd.2018.02.81

Abstract

BACKGROUND: The aim of the present study is to identify the incidence and prognostic significance of lymph node metastases near the celiac trunk in patients who underwent neoadjuvant chemo(radio)therapy followed by esophagectomy.

METHODS: Between March 1994 and September 2013 a total of 462 consecutive patients with cancer of the esophagus or gastroesophageal junction (GEJ) who underwent potentially curative esophageal resection after neoadjuvant chemotherapy (N=88; 19.0%) or neoadjuvant chemoradiotherapy (CRT) (N=374; 81.0%) were included.

RESULTS: Seventy one (15.4%) patients had truncal node metastases in the resection specimen. Metastases to these nodes occurred more frequently in male patients with adenocarcinoma and in tumors at the gastro-esophageal junction. A lower response to neoadjuvant treatment, higher ypT and ypN stages and a poorer grade of differentiation were significantly related with truncal node metastases. Patients with tumor positive truncal nodes had a worse median overall survival (17

CONCLUSIONS: In the present study, it is demonstrated that positive truncal nodes in the resection specimen after neoadjuvant therapy, are associated with advanced tumor stages and are an independent factor for inferior survival.

Keywords: Esophageal carcinoma; neoadjuvant therapy; truncal node metastases

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

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