Solitary Nodal Recurrence in the Dorsal Area of the Thoracic Aorta After a Curative Resection of Esophageal Cancer: Report of Two Cases

Kaisaki, Shoichi; Kitayama, Joji; Ishigami, Hironori; Nagawa, Hirokazu

doi:10.1007/s00595-006-3349-8

Cited by 8 publications

(3 citation statements)

References 14 publications

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“…However, Nakagawa et al reported a case that underwent DTA dissection and died 10 months after the surgery owing to recurrence around the trachea [16] . Kaisaki et al reported two patients with dissection of lymph nodes in the DTA, who showed prolonged survival of 60 months and 12 months [17] . Hatooka et al reported two esophageal cancer patients with metastasis in the DTA, who died 19 months and 23 months after chemoradiotherapy, and another patient treated with neoadjuvant chemotherapy, followed by esophagectomy and dissection of lymph nodes in the DTA, who survived for 46 months after the operation without any recurrence [1] .…”

Section: Discussionmentioning

confidence: 99%

Bilateral approach for thoracoscopic esophagectomy with lymph node dissection in the dorsal area of the thoracic aorta in patients with esophageal cancer: A report of two cases

Onodera

Nakano

Heishi

et al. 2017

International Journal of Surgery Case Reports

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HighlightsWe presented two esophageal cancer patients performed thoracoscopic esophagectomy.These two cases have lymph node metastasis of dorsal area of thoracic aorta (DTA).We performed successfully underwent the dissection of lymph node of DTA.The bilateral thoracoscopic approach performedsafely in the prone position.The long-term outcome of lymphadenectomy in the DTA among esophageal cancer patients remain controversial.

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Section: Discussionmentioning

confidence: 99%

Bilateral approach for thoracoscopic esophagectomy with lymph node dissection in the dorsal area of the thoracic aorta in patients with esophageal cancer: A report of two cases

Onodera

Nakano

Heishi

et al. 2017

International Journal of Surgery Case Reports

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“…Recurrence after radical esophagectomy has been reported in the distant viscera, the locoregional area, and at multiple sites [8]. A report described two patients with solitary nodal recurrence in the dorsal area of the thoracic aorta after curative resection of esophageal cancer [9]. This area is therefore a site of tumor recurrence after curative surgery operation.…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic radical esophagectomy and laparoscopic transhiatal lymph node dissection for superficial esophageal cancer associated with lymph node metastases in the dorsal area of the thoracic aorta

et al. 2015

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Esophageal cancer invading the muscularis mucosa sometimes involves regional lymph node metastases. However, lymph node metastases are rare in the dorsal area of the thoracic aorta. We describe a patient with an intramucosal esophageal cancer invading the muscularis mucosa, accompanied by lymph node metastases in the dorsal area of the thoracic aorta. These lesions were successfully resected by hand-assisted laparoscopic surgery using a transhiatal approach. A 60-year-old man was diagnosed with superficial esophageal cancer during a routine health examination. Endoscopic examination and ultrasonography revealed a superficial cancer, of diameter 6.0 cm, invading the submucosal layer and intramural metastases caudal to the primary tumor. Enhanced computed tomography and F-deoxyglucose positron emission tomography demonstrated the two metastatic lymph nodes, one in the dorsal area of the thoracic aorta and the other near the left gastric artery. Thoracoscopic radical esophagectomy with three-field lymph node dissection was performed. The metastatic lymph node in the dorsal area of the thoracic aorta was successfully removed by hand-assisted laparoscopic surgery using a transhiatal approach. Histopathological examination showed primary cancer invading the muscularis mucosa and intramural metastases in the lamina propria mucosa and submucosal layer. The pathological diagnosis according to the Japanese classification of esophageal cancer was MtLt, 47 mm, 0-IIa + IIb, pT1a-MM, ie(+), INF-b, ly3, v0, pN4(4a), pIM1, M0, and pstage IVa. The patient underwent two courses of adjuvant chemotherapy, consisting of CDDP and 5-fluorouracil. At present, 1 year and 8 months after surgery, the patient remains alive without tumor recurrence. Although the lymph node in the dorsal area of the thoracic aorta is not recognized as regional nodes of thoracic esophageal cancer, solitary mediastinal metastases from a mucosal cancer may indicate the existence of direct lymphatic flow from the thoracic esophagus to the retroaortic region. Transhiatal approach by hand-assisted laparoscopic surgery is useful to dissect the metastatic lymph node in the dorsal area of the thoracic aorta.

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“…If recurrence is solitary or localized, which occurs in very few patients, a salvage operation is indicated. PDG-PET is useful in judging whether recurrence is solitary or multiple [8,9].…”

Section: Discussionmentioning

confidence: 99%

The use of minimally invasive surgery for lymph node recurrence after endoscopic mucosal resection of superficial esophageal cancer

et al. 2009

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A 73-year-old man was diagnosed with superfi cial esophageal cancer, and endoscopic mucosal resection was performed. Histologically, the lesion was found to be a squamous cell carcinoma invading the muscularis mucosae without vascular invasion. The patient was followed without being given adjuvant therapy, and lymph node recurrence along the lesser curvature of the stomach was found after 2.5 years. He underwent laparoscopic removal of the metastatic lymph node and cholecystectomy for cholecystolithiasis. He had two courses of adjuvant chemotherapy and showed no recurrence during 3 years of observation. Although the effectiveness of surgical resection for nodal recurrence of esophageal cancer remains controversial, this case highlights the possibility of salvage resection using minimally invasive surgery.

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Solitary Nodal Recurrence in the Dorsal Area of the Thoracic Aorta After a Curative Resection of Esophageal Cancer: Report of Two Cases

Cited by 8 publications

References 14 publications

Bilateral approach for thoracoscopic esophagectomy with lymph node dissection in the dorsal area of the thoracic aorta in patients with esophageal cancer: A report of two cases

Bilateral approach for thoracoscopic esophagectomy with lymph node dissection in the dorsal area of the thoracic aorta in patients with esophageal cancer: A report of two cases

Thoracoscopic radical esophagectomy and laparoscopic transhiatal lymph node dissection for superficial esophageal cancer associated with lymph node metastases in the dorsal area of the thoracic aorta

The use of minimally invasive surgery for lymph node recurrence after endoscopic mucosal resection of superficial esophageal cancer

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