Outcomes of Extended Radical Esophagectomy for Thoracic Esophageal Cancer

Nishimaki, Tadashi; Suzuki, Tsutomu; Suzuki, Satoshi; Kuwabara, Shirou; Hatakeyama, Katsuyoshi

doi:10.1016/s1072-7515(98)00013-1

Cited by 159 publications

(112 citation statements)

References 14 publications

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“…In a previous study, cure was likely only in patients who had four or fewer positive nodes (5-year survival rate was 71 per cent for patients with negative nodes and 36 per cent for those with one to four positive nodes), whereas the prognosis was extremely poor in patients with ®ve or more positive nodes, even after extended radical oesophagectomy combined with three-®eld lymphadenectomy 6 . These data suggest that patients with four or fewer overt positive nodes have potentially curable oesophageal cancer.…”

Section: Discussionmentioning

confidence: 87%

“…The technique of radical oesophagectomy with extensive lymphadenectomy has been reported in detail elsewhere 6 . Lymph nodes resected were de®ned using the nomenclature of the Japanese Society for Oesophageal Diseases 11 .…”

Section: Lymph Node Resectionmentioning

confidence: 99%

“…Previously, the authors showed that cure is likely only in patients with four or fewer metastatic nodes (5-year survival rate 71 per cent for patients with negative nodes and 36 per cent for those with one to four positive nodes), whereas no patient with ®ve or more positive nodes survived more than 5 years after oesophageal resection. Therefore, patients with oesophageal carcinoma and four or fewer positive nodes are potentially curable 6 .…”

Section: Introductionmentioning

confidence: 99%

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Significance of immunohistochemical nodal micrometastasis as a prognostic indicator in potentially curable oesophageal carcinoma

Komukai

Nishimaki

Suzuki

et al. 2002

British Journal of Surgery

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Background: The number of positive lymph nodes is an important prognostic predictor in patients with oesophageal cancer. However, the signi®cance of nodal micrometastasis in patients with overt nodal metastasis is unknown. The aim of this study was to clarify the clinical implications of nodal micrometastasis in patients undergoing curative oesophagectomy for oesophageal cancer.Methods: Cervical, mediastinal and abdominal lymph nodes systematically removed from 104 patients with oesophageal cancer were examined immunohistochemically to detect cells that stained positively for cytokeratins with the monoclonal antibody cocktail AE1/AE3. The postoperative course and survival rates were compared among patients with and without micrometastases, after numerical classi®cation of overt metastatic nodes (none, between one and four, ®ve or more).Results: Univariate analysis showed T stage, nodal micrometastasis and number of overt nodal metastases to be signi®cant prognostic factors after oesophagectomy. Multivariate analysis revealed nodal micrometastasis and number of overt nodal metastases to be independent prognostic factors. The presence of micrometastases had a signi®cant adverse effect on postoperative survival in patients with no overt metastasis and in patients with one to four overt metastatic nodes, but no such impact in patients with ®ve or more overt metastatic nodes.Conclusion: Assessment of nodal status by both histological examination for overt metastases and immunohistochemical examination for micrometastases is useful in stratifying patients undergoing curative oesophagectomy.

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Section: Discussionmentioning

confidence: 87%

Section: Lymph Node Resectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Significance of immunohistochemical nodal micrometastasis as a prognostic indicator in potentially curable oesophageal carcinoma

Komukai

Nishimaki

Suzuki

et al. 2002

British Journal of Surgery

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“…However, the spread of cancer cells to extracapsular connective tissues surrounding the lymph nodes, called extranodal metastasis EM [1][2][3] , is also often found during detailed histological investigations of resected lymph nodes in squamous cell carcinoma of the esophagus. EM has also been reported in carcinomas of the stomach [4][5][6][7] , rectum 8,9 , thyroid 10,11 , breast 12,13 , vulva 14 , and lung 15,16 , and such metastasis has been linked to the rate of disease progression.…”

Section: Introductionmentioning

confidence: 99%

“…EM has also been reported in carcinomas of the stomach [4][5][6][7] , rectum 8,9 , thyroid 10,11 , breast 12,13 , vulva 14 , and lung 15,16 , and such metastasis has been linked to the rate of disease progression. However, few studies have examined the impact of EM on prognosis in patients with squamous cell carcinoma of the esophagus 2,17 , prompting this study aimed at clarifying the clinicopathological signi cance of EM in this patient group.…”

Section: Introductionmentioning

confidence: 99%

Correlations between Extranodal Metastasis and Prognosis in Patients with Squamous Cell Carcinoma of the Esophagus

Otsuka

Murakami

Tajima

et al. 2012

Showa Univ J Med Sci

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: Background Extranodal metastasis EM has been reported in carcinomas of many organs. However, the clinicopathological signi cance of EM in squamous cell carcinoma of the esophagus remains unclear, and this study sought to clarify this issue. Methods This study included 220 patients who underwent an esophagectomy with lymphadenectomy for primary esophageal carcinoma from 1996 to 2008. EM was defined as the presence of cancer cells in the soft tissue that were discontinuous with the primary lesion, or in the perinodal soft tissue distinct from the lymph nodes. Results EM was detected in 25 9.6 of the 220 patients, and in 56 0.7 of the 8,186 nodules retrieved as lymph nodes . The incidence of EM was signi cantly higher in patients who had tumors of a larger size diameter ≥ 4 cm , lymphatic vessel invasion, lymph node metastasis, a high pathological stage, infiltrative growth pattern, or a high pT-stage. The 5-year overall survival rates in N0-1 patients with EM were significantly lower than in the patients without EM P 0.005 . Conclusion EM is closely associated with the development and aggressiveness of esophageal carcinoma, and the presence of EM can be useful for predicting prognosis after surgery in N0-1esophageal carcinoma patients.

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Prognostic Factors in T1 and T2 Squamous Cell Carcinoma of the Thoracic Esophagus

Tachibana

Kinugasa²,

Dhar³

et al. 1999

Arch Surg

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Background: Prognostic indicators in patients with T2 tumor have not been fully understood. Objective: To clarify the clinicopathologic characteristics and long-term results of T1 and T2 squamous cell carcinomas of the thoracic esophagus. Design: Consecutive case series. Setting: Department of surgery in a university hospital. Patients: Of 234 patients with primary squamous cell carcinoma of the thoracic esophagus, 142 patients underwent esophagectomy with curative intent: 97 patients had pT1 and pT2 tumors. Interventions: Investigated were clinicopathologic characteristics of 65 of 97 patients with pT1 and pT2 tumors; excluded were 7 patients who died of postoperative complications and another 25 patients who died of causes other than esophageal cancer. Main Outcome Measures: Clinicopathologic characteristics and long-term results. Results: Pathologic tumor stages were pT1 N0 in 23 patients, pT1 N(+) in 7 patients, pT2 N0 in 15 patients, and pT2 N(+) in 20 patients. Fifty patients are alive and free of

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Outcomes of Extended Radical Esophagectomy for Thoracic Esophageal Cancer

Cited by 159 publications

References 14 publications

Significance of immunohistochemical nodal micrometastasis as a prognostic indicator in potentially curable oesophageal carcinoma

Significance of immunohistochemical nodal micrometastasis as a prognostic indicator in potentially curable oesophageal carcinoma

Correlations between Extranodal Metastasis and Prognosis in Patients with Squamous Cell Carcinoma of the Esophagus

Prognostic Factors in T1 and T2 Squamous Cell Carcinoma of the Thoracic Esophagus

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