Distribution of Lymph Node Metastasis in Esophageal Squamous Cell Carcinoma After Trimodal Therapy

Hamai, Yoichi; Emi, Manabu; Ibuki, Yuta; Kurokáwa, Tomonori; Yoshikawa, Toru; Ohsawa, Manato; Hirohata, Ryosuke; Murakami, Yuji; Nishibuchi, Ikuno; Imano, Nobuki; Nagata, Yasushi; Okada, Morihito

doi:10.1245/s10434-020-09106-0

Cited by 22 publications

(15 citation statements)

References 22 publications

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“… 29 The efficacy of lymphadenectomy would differ depending on the perioperative therapy and its response. 30 , 31 Thus, a larger study focusing on patients with or without neoadjuvant therapy would be more useful in developing an individualized treatment strategy for EC.…”

Section: Surgical Approach To Eradicating a Wide Range Of Ln Metastas...mentioning

confidence: 99%

Lymph node metastatic patterns and the development of multidisciplinary treatment for esophageal cancer

Matsuda

Takeuchi

Kawakubo

et al. 2023

Diseases of the Esophagus

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Summary Abundant lymphatic flow and the anatomical location of the esophagus can result in the widespread distribution of lymph node metastasis of esophageal cancer from the cervical to the abdominal field. Historically, the Japan Esophageal Society and American Joint Committee on Cancer offer two different classifications of lymph node group location surrounding the esophagus. The location of sentinel lymph nodes in midthoracic esophageal cancer reflects the variety of lymphatic drainage routes. In fact, in cT1N0 esophageal cancer, pathological lymph node metastasis has been observed from the cervical to the abdominal field, and the locations were shown to be closely linked to the primary tumor location in advanced stages. While the impact of histology on the distribution of LN metastasis has been extensively debated, a recent prospective study on esophagogastric junction cancer found that metastatic patterns did not differ by histology. Thoracic duct lymph nodes were defined as one of the regional lymph node stations in the mediastinum. Although lymph node metastasis around the thoracic duct has occasionally been observed, the oncologic impact of thoracic duct lymph node dissection has not been fully elucidated. To eradicate tumors locoregionally, three-field lymph node dissection, a strategy for extended lymph node clearance, has been established. In esophagectomy, three-field lymph node dissection is defined as a procedure for complete regional cervico-thoraco-abdominal lymph node dissection. However, its therapeutic efficacy must be evaluated based on the balance between oncological outcomes and possible added surgical risk. To further improve survival, multidisciplinary treatment consisting of surgery, chemotherapy, and radiotherapy has been established worldwide as a standard treatment for esophageal cancer. Now that neoadjuvant therapy followed by esophagectomy is the standard, adding adjuvant therapy including immunotherapy could be a promising treatment option. The ideal combination of various multidisciplinary treatment approaches and extensive LN dissection need to be established to improve the oncological outcomes for EC patients.

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Section: Surgical Approach To Eradicating a Wide Range Of Ln Metastas...mentioning

confidence: 99%

Lymph node metastatic patterns and the development of multidisciplinary treatment for esophageal cancer

Matsuda

Takeuchi

Kawakubo

et al. 2023

Diseases of the Esophagus

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“…Surgical and survival outcomes were assessed in patients with D-cT3 and BR-cT3 ESCC. The included patients duplicated our previous retrospective studies [10][11][12][13]16], and those diagnosed with cT3 in these studies were classified as D-cT3 and BR-cT3. Survival outcomes were evaluated on January 2021.…”

Section: Patientsmentioning

confidence: 99%

“…We investigated the prognostic factors of patients who underwent surgery after NCRT for ESCC [10][11][12][13]. In our previous reports, we diagnosed borderline resectable ESCC (BR-ESCC), known as borderline resectable cT3 (BR-cT3), as clinical T3, and attempted to perform surgery after NCRT.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Neoadjuvant Chemoradiotherapy Followed by Surgery for Borderline Resectable Esophageal Squamous Cell Carcinoma

et al. 2022

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Background It is occasionally difficult to diagnose cT3 or cT4b using imaging examinations for esophageal cancer. The optimal treatment strategy for borderline resectable esophageal squamous cell carcinoma (BR-ESCC) is unclear. Methods We included 131 patients with cT3 ESCC who received neoadjuvant chemoradiotherapy (NCRT) followed by surgery. The patients were classified as having definitive cT3 (D-cT3) or borderline resectable cT3 (BR-cT3), based on presence of undeniable adjacent organ invasion on pretreatment CT. Surgical outcomes and prognoses were compared among patients with D-cT3 and BR-cT3 tumors, and the risk factors for non-R0 resection were assessed. Results Ninety and 41 patients were classified as D-cT3 and BR-cT3, respectively. Although BR-cT3 had a significantly higher non-R0 resection rate than D-cT3 (D-cT3 3.7%; BR-cT3 14.6%), BR-cT3 was not correlated with shorter overall survival (OS) (D-cT3 5-year OS, 50.8%; BR-cT3 5-year OS 38.4%; p = 0.234). Conversely, non-R0 resection was significantly associated with poor OS (R0 resection 5-year OS 48.8%; non-R0 resection 5-year OS 22.2%; p = 0.031). Cox regression analysis of OS demonstrated that BR-cT3 was not a prognostic factor. In the analysis of risk factors for non-R0 resection, BR-cT3 (p = 0.027), suspected invasion of the trachea or bronchus (p = 0.046), and high SUVmax of the primary lesion after NCRT (p = 0.002) were risk factors. Conclusions NCRT followed by surgery achieved a relatively high R0 resection rate and an almost equal overall survival rate for BR-cT3 compared with D-cT3 ESCC. Thus, NCRT followed by surgery is an effective treatment strategy for patients with BR-cT3 ESCC.

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“…Due to the early transferability of ESCC, the 5-year overall survival rate for ESCC patients remains below 20% [ 2 ]. With the rapid increase in ESCC incidence and mortality, it is estimated that more than 1 million new cases will suffer from ESCC in the next decade [ 3 ]. Current clinical treatment methods for ESCC patients include surgery and adjuvant chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Tumor-associated fibroblasts derived exosomes induce the proliferation and cisplatin resistance in esophageal squamous cell carcinoma cells through RIG-I/IFN-β signaling

Cui

Zhang

et al. 2022

Bioengineered

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Esophageal squamous cell carcinoma (ESCC) is a common type of malignant cancer. There is growing evidence suggesting that exosomes may participate in the cellular communication of tumor-associated fibroblasts (TAFs). However, the cisplatin resistance of TAF-derived exosomes to ESCC cells remains to be further studied. Exosomes were isolated from TAFs and characterized with Western blot and TEM assays. ESCC cell lines (TE-1 and KYSE-150) were incubated with TAFs-derived exosomes. To explore the biological function of TAF-derived exosomes in ESCC cell proliferation, apoptosis, and chemosensitivity, we conducted MTT assays and Flow Cytometry. The effects in vivo were also verified via Xenograft mice models. We found that TAFs-derived exosomes led to enhanced cell proliferation and reduced apoptosis of cells, accompanied by increased expression of RIG-I/IFN-β, and TAFs derived exosomes may affect the chemosensitivity to cisplatin via RIG-I/IFN-β signaling in ESCC. Taken together, ESCC cells could communicate with TAFs cells via TAFs-derived exosomes. Our findings might represent a novel mechanism involved in ESCC and may provide a potential biomarker for ESCC.

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Distribution of Lymph Node Metastasis in Esophageal Squamous Cell Carcinoma After Trimodal Therapy

Cited by 22 publications

References 22 publications

Lymph node metastatic patterns and the development of multidisciplinary treatment for esophageal cancer

Lymph node metastatic patterns and the development of multidisciplinary treatment for esophageal cancer

Evaluation of Neoadjuvant Chemoradiotherapy Followed by Surgery for Borderline Resectable Esophageal Squamous Cell Carcinoma

Tumor-associated fibroblasts derived exosomes induce the proliferation and cisplatin resistance in esophageal squamous cell carcinoma cells through RIG-I/IFN-β signaling

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