Mucosal lymphatic vessels of the esophagus distant from the cancer margin: morphometrical analysis using 27 surgically removed specimens of squamous cell carcinoma located in the upper or middle thoracic esophagus

Nishimori, Hidefumi; Hayashi, Shogo; Naito, Makoto; Murakami, Gen; Fujita, Masahiro; Hosokawa, Masao

doi:10.2535/ofaj.88.43

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…The innermost layer is multi-layered squamous epithelium without keratinization and it folds along papillae 15,20,21,23. The basement lamina is approximately 50–80 µm and discontinuous.…”

Section: Anatomy Of Lymphatic Drainagementioning

confidence: 99%

“…The lymphatic vessels are thought to be not obvious because of low LNMR when tumor invades this layer. It has been proved that lymphatic vessels are densely arranged in the lamina propria, and most of them run longitudinally while limited circumferentially 20,21,23,27. There are no lymphatic vessels connected to intermuscular and extramural lymphatic vessels directly, which may be an explanation for low LNMR.…”

Section: Anatomy Of Lymphatic Drainagementioning

confidence: 99%

“…There are no lymphatic vessels connected to intermuscular and extramural lymphatic vessels directly, which may be an explanation for low LNMR. The mucosal vessel density has a great interindividual variation 20,21,27…”

Section: Anatomy Of Lymphatic Drainagementioning

confidence: 99%

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Anatomy of lymphatic drainage of the esophagus and lymph node metastasis of thoracic esophageal cancer

Wang¹,

Zhu²,

Xia³

et al. 2018

CMAR

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The lymphatic drainage of the inner layers (mucosa and submucosa) and the outer layers (muscularispropria and adventitia) of the thoracic esophagus is different. Longitudinal lymphatic vessels and long drainage territory in the submucosa and lamina propria should be the bases for bidirectional drainage and direct drainage to thoracic duct and extramural lymph nodes (LN). The submucosal vessels for direct extramural drainage are usually thick while lymphatic communication between the submucosa and intermuscular area is usually not clearly found, which does not facilitate transversal drainage to paraesophageal LN from submucosa. The right paratracheal lymphatic chain (PLC) is well developed while the left PLC is poorly developed. Direct drainage to the right recurrent laryngeal nerve LN and subcarinal LN from submucosa has been verified. Clinical data show that lymph node metastasis (LNM) is frequently present in the lower neck, upper mediastinum, and perigastric area, even for early-stage thoracic esophageal cancer (EC). The lymph node metastasis rate (LNMR) varies mainly according to the tumor location and depth of tumor invasion. However, there are some crucial LN for extramural relay which have a high LNMR, such as cervical paraesophageal LN, recurrent laryngeal nerve LN, subcarinal LN, LN along the left gastric artery, lesser curvature LN, and paracardial LN. Metastasis of thoracic paraesophageal LN seems to be a sign of more advanced EC. This review gives us a better understanding about the LNM and provides more information for treatments of thoracic EC.

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Section: Anatomy Of Lymphatic Drainagementioning

confidence: 99%

Section: Anatomy Of Lymphatic Drainagementioning

confidence: 99%

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Anatomy of lymphatic drainage of the esophagus and lymph node metastasis of thoracic esophageal cancer

Wang¹,

Zhu²,

Xia³

et al. 2018

CMAR

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The impact of adjuvant therapies on patient survival and the recurrence patterns for resected stage IIa–IVa lower thoracic oesophageal squamous cell carcinoma

Wang¹,

Zhu²,

Xia³

et al. 2018

World J Surg Onc

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BackgroundThis study evaluated the impact of adjuvant therapies on patient survival and disease recurrence patterns to identify an effective adjuvant therapy for resected lower thoracic oesophageal squamous cell carcinoma (LTESCC).MethodsClinical data of 127 patients with stage IIa-IVa LTESCC with a minimum 2-year follow-up after oesophagectomy were analysed. The survival and recurrence patterns were compared among patients who received adjuvant radiotherapy, adjuvant chemotherapy, adjuvant chemoradiotherapy, or surgery alone.ResultsEighty-eight patients (69.3%) were identified as having disease recurrence. The regional lymph node recurrence rate was 57.5%, and the recurrence rates were high in the lower neck, upper mediastinum, and upper abdomen. Compared to surgery alone, adjuvant radiotherapy or chemoradiotherapy significantly decreased the recurrence rate (p < 0.05). Adjuvant chemoradiotherapy significantly improved overall survival, disease-free survival, and locoregional recurrence-free survival compared to surgery alone (p = 0.01, 0.01, and 0.00, respectively). Pathologically positive lymph nodes (PPLNs) in the lower mediastinum represented a potential risk factor for cervical recurrence (HR 2.97, 95%CI 1.19–7.39). Multivariable analysis showed that postoperative radiotherapy (HR 0.30, 95%CI 0.13–0.68) and PPLNs in the upper mediastinum (HR 3.72, 95%CI 1.30–10.67) were independent risk factors for upper mediastinal recurrence, while postoperative radiotherapy (HR 0.37, 95%CI 0.16–0.85) and PPLNs in the abdomen (HR 2.57, 95%CI 1.12–5.92) were independent risk factors for abdominal recurrence.ConclusionAdjuvant chemoradiotherapy was the most effective adjuvant therapy for resected stage IIa-IVa LTESCC. The lower neck, upper mediastinum, and upper abdomen were high-risk regions for postoperative radiotherapy. The regions of PPLNs may be important factors for individual targets.

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Progress of magnetic resonance imaging radiomics in preoperative lymph node diagnosis of esophageal cancer

Xu¹,

Lu²,

Gao³

et al. 2023

World J Radiol

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Esophageal cancer, also referred to as esophagus cancer, is a prevalent disease in the cardiothoracic field and is a leading cause of cancer-related mortality in China. Accurately determining the status of lymph nodes is crucial for developing treatment plans, defining the scope of intraoperative lymph node dissection, and ascertaining the prognosis of patients with esophageal cancer. Recent advances in diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging (MRI) have improved the effectiveness of MRI for assessing lymph node involvement, making it a beneficial tool for guiding personalized treatment plans for patients with esophageal cancer in a clinical setting. Radiomics is a recently developed imaging technique that transforms radiological image data from regions of interest into high-dimensional feature data that can be analyzed. The features, such as shape, texture, and waveform, are associated with the cancer phenotype and tumor microenvironment. When these features correlate with the clinical disease outcomes, they form the basis for specific and reliable clinical evidence. This study aimed to review the potential clinical applications of MRI-based radiomics in studying the lymph nodes affected by esophageal cancer. The combination of MRI and radiomics is a powerful tool for diagnosing and treating esophageal cancer, enabling a more personalized and effectual approach.

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Mucosal lymphatic vessels of the esophagus distant from the cancer margin: morphometrical analysis using 27 surgically removed specimens of squamous cell carcinoma located in the upper or middle thoracic esophagus

Cited by 3 publications

References 15 publications

Anatomy of lymphatic drainage of the esophagus and lymph node metastasis of thoracic esophageal cancer

Anatomy of lymphatic drainage of the esophagus and lymph node metastasis of thoracic esophageal cancer

The impact of adjuvant therapies on patient survival and the recurrence patterns for resected stage IIa–IVa lower thoracic oesophageal squamous cell carcinoma

Progress of magnetic resonance imaging radiomics in preoperative lymph node diagnosis of esophageal cancer

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