The significance of subcarinal dissection in esophageal cancer surgery

Hu, Wei; Liang, Yayong; Zhang, Shuishen; Hu, Yi; Liu, Jingeng

doi:10.1111/ajco.12095

Cited by 13 publications

(10 citation statements)

References 17 publications

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“…Increasing evidences suggest that AEJ is different from gastric and esophageal adenocarcinoma in molecular features, pathological evolution, and clinical behavior [ 4 ]. The prognosis of AEJ patients remains still poor (five-year survival rate, 10%-15%), which is poorer than those with other gastric cancers [ 5 ], because most of these patients are diagnosed at an advanced stage. The diagnosis and prognosis promise of many molecular targeted agents that have been characterized in other tumors are still unclear in AEJ [ 6 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

Association of HOTAIR expression with PI3K/Akt pathway activation in adenocarcinoma of esophagogastric junction

Zhang

Meng

2016

Open Medicine

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AbstractObjectivesAlthough the Hox transcript antisense intergenic RNA (HOTAIR), a vital long non-coding RNA, is known to participate in the development and progression of a wide range of carcinomas, there are still no published reports regarding its expression in adenocarcinoma of esophagogastric junction (AEJ). The aims of this study were to investigate the expression of HOTAIR, and to analyze the association of its expression with PI3K/Akt pathway activation in clinical AEJ patients.MethodsNine normal epithelial tissues and 41 samples of AEJ were studied comparably. The expression of HOTAIR was detected by real-time PCR according to the different tumor grades in these AEJ tissues. Western blot was performed to reveal the Ser473-phosphorylated Akt and total Akt levels. Results: HOTAIR was found to be up-regulated in higher grades of AEJ tissues compared to low grades and/or noncancerous tissues. pAkt expression was also found to be up-regulated in tissues of higher tumor stages. We found that the overexpression of HOTAIR finely correlated with elevated Ser473-phosphorylated Akt levels. Conclusion: Upregulated HOTAIR was associated with abnormal activated PI3K/Akt pathway, which might serve as a promising therapeutic strategy for AEJ treatment.

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Section: Introductionmentioning

confidence: 99%

Association of HOTAIR expression with PI3K/Akt pathway activation in adenocarcinoma of esophagogastric junction

Zhang

Meng

2016

Open Medicine

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“…Previous studies reported subcarinal node metastasis indicated worse prognosis10, 11, 28, 29. Given that subcarinal node metastasis was more likely associated with an advanced disease status, the value of subcarinal node dissection in thoracic ESCC was also investigated.…”

Section: Discussionmentioning

confidence: 99%

Is Routine Subcarinal Lymph Node Dissection Necessary in Superficial Esophageal Squamous Cell Carcinoma? A Propensity Score Matching Analysis

Tang¹,

Tan²,

Wang³

et al. 2019

J. Cancer

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Background: The purpose of this study was to investigate the impact of subcarinal lymph node dissection on short-term and long-term outcomes after esophagectomy in patients with superficial esophageal squamous cell carcinoma (ESCC). Methods: From January 2010 to December 2015, 490 patients with pT1 ESCC were enrolled in the study. Patients in subcarinal dissection or non-dissection group were matched randomly in a 2:1 ratio, eventually, 255 patients were selected for further statistical analysis. Results: The metastasis rate of subcarinal lymph nodes in superficial ESCC was 1.24% and significantly lower than the other stations (7.14-9.96%). Compared with dissection group, non- dissection group had shorter operation time (193±35 vs. 204±39, P=0.016), less blood loss (157±48 vs. 178±29, P=0.011) as well as lower incidence of pulmonary complications (9.4 vs. 20%, P=0.032). At a median follow-up of 46 months, the recurrent rate in each group was similar (16.5 vs. 15.3%, P=0.809). Survival analysis revealed no overall survival (P=0.992) and disease-free survival (P=0.665) reductions in non-dissection group. In univariate and multivariate analyses, subcarinal lymph node dissection was not a predictive factor of overall and disease-free survival in superficial ESCC. Conclusion: Subcarinal lymph node dissection was not beneficial and could be omitted in superficial ESCC.

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“…Subcarinal lymph node dissection is the standard operative strategy for thoracic esophageal cancer [1–3]. Though rare, right superior pulmonary vein (RSPV) anomaly runs behind the right main or intermediate bronchus [4–6].…”

Section: Introductionmentioning

confidence: 99%

Thoracoscopic esophagectomy with subcarinal lymph node dissection in the prone position for esophageal cancer with a right superior pulmonary vein anomaly: a case report

et al. 2019

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BackgroundSuperior posterior pulmonary vein anomaly in the right upper lobe (anomalous V2), which is one of the anomalies of the right superior pulmonary vein (RSPV), runs behind the right main or intermediate bronchus. Although this rarely occurs, attention should be given to this venous anomaly during thoracoscopic esophagectomy with subcarinal lymph node dissection. Here, we report a case of thoracoscopic esophagectomy with subcarinal lymph node dissection in the prone position for lower thoracic esophageal cancer with anomaly of the superior posterior pulmonary vein in the right lobe (anomalous V2).Case presentationA 61-year-old man was diagnosed as having lower esophageal cancer with swelling of multiple lymph nodes in the mediastinum and abdomen. His clinical diagnosis based on the eighth TNM classification system was cT3 N2 M0 stage IIIB. In addition, an anomalous V2 was recognized on preoperative computed tomography imaging before the operation. The vein ran behind the intermediate bronchus and drained into the RSPV located at the area of the subcarinal lymph node. We performed preoperative simulation by using virtual thoracoscopic imaging with the same view as that during operation to help us better dissect the lymph nodes. As a result, thoracoscopic esophagectomy and subcarinal lymph node dissection were performed in the prone position without injuring the anomalous V2. Severe complications did not occur in the postoperative course except for paralysis of the left recurrent laryngeal nerve. The patient was discharged on postoperative day 17.ConclusionsInjury to an anomalous V2 can cause severe hemorrhage during subcarinal lymph node dissection in esophagectomy. Preoperative simulation by using virtual thoracoscopic imaging is useful to avoid this complication in patients with an anatomical anomaly.

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The significance of subcarinal dissection in esophageal cancer surgery

Abstract: Subcarinal dissection is still necessary in esophagectomy for esophageal squamous cell carcinoma.

Cited by 13 publications

References 17 publications

Association of HOTAIR expression with PI3K/Akt pathway activation in adenocarcinoma of esophagogastric junction

Association of HOTAIR expression with PI3K/Akt pathway activation in adenocarcinoma of esophagogastric junction

Is Routine Subcarinal Lymph Node Dissection Necessary in Superficial Esophageal Squamous Cell Carcinoma? A Propensity Score Matching Analysis

Thoracoscopic esophagectomy with subcarinal lymph node dissection in the prone position for esophageal cancer with a right superior pulmonary vein anomaly: a case report

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