Lymph Node Harvest in Esophageal Cancer After Neoadjuvant Chemoradiotherapy
Background This study was designed to determine the effects of lymph node (LN) harvest on survival in esophageal cancer after neoadjuvant chemoradiation (nCRT). Methods An analysis of surgically resected esophageal cancer patients after nCRT was performed to determine an association between the numb...
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| Veröffentlicht in: | Annals of surgical oncology 2013-09, Vol.20 (9), p.3038-3043 |
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| creator | Shridhar, Ravi Hoffe, Sarah E. Almhanna, Khaldoun Weber, Jill M. Chuong, Michael D. Karl, Richard C. Meredith, Kenneth |
| description | Background
This study was designed to determine the effects of lymph node (LN) harvest on survival in esophageal cancer after neoadjuvant chemoradiation (nCRT).
Methods
An analysis of surgically resected esophageal cancer patients after nCRT was performed to determine an association between the number of LNs resected and survival. Overall survival (OS) and disease-free survival (DFS) curves were calculated according to the Kaplan–Meier method and log-rank analysis. Multivariate analysis (MVA) was performed by the Cox proportional hazard model.
Results
We identified 358 patients with a mean follow-up of 27.3 months. The number of LN removed was not impacted by the type of surgical procedure. The number of LNs removed ( |
| doi_str_mv | 10.1245/s10434-013-2988-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1418143851</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1418143851</sourcerecordid><originalsourceid>FETCH-LOGICAL-p282t-502b76f4026c7c4889a133a081691a44c42704af15369d868041b55a3eeea7513</originalsourceid><addsrcrecordid>eNpdkU1PwzAMhiMEgjH4AVxQJS5cCnHipOkRTcAQ07jAOfLa7EvrB0mLtH9PxoaEuNiW_ch67ZexK-B3IFDdB-AoMeUgU5Ebk-IRG4CKHdQGjmPNtUlzodUZOw9hzTlkkqtTdiakFgpQDNjrZFu1y2TalC4Zk_9yoUtWdfIYmnZJC0ebZER14XzyMO9inLqGynX_RXWXjJauajyVq6ZbOk_t9oKdzGkT3OUhD9nH0-P7aJxO3p5fRg-TtBVGdKniYpbpOXKhi6xAY3ICKYkb0DkQYoEi40jzeInOS6MNR5gpRdI5R5kCOWS3-72tbz77qNhWq1C4zYZq1_TBAoIBlOYHvfmHrpve11HdjsqQQ57vqOsD1c8qV9rWryryW_v7pgiIPRDiqF44_2cNtzsv7N4LG72wOy8sym_t2Xbs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1417401991</pqid></control><display><type>article</type><title>Lymph Node Harvest in Esophageal Cancer After Neoadjuvant Chemoradiotherapy</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Shridhar, Ravi ; Hoffe, Sarah E. ; Almhanna, Khaldoun ; Weber, Jill M. ; Chuong, Michael D. ; Karl, Richard C. ; Meredith, Kenneth</creator><creatorcontrib>Shridhar, Ravi ; Hoffe, Sarah E. ; Almhanna, Khaldoun ; Weber, Jill M. ; Chuong, Michael D. ; Karl, Richard C. ; Meredith, Kenneth</creatorcontrib><description>Background
This study was designed to determine the effects of lymph node (LN) harvest on survival in esophageal cancer after neoadjuvant chemoradiation (nCRT).
Methods
An analysis of surgically resected esophageal cancer patients after nCRT was performed to determine an association between the number of LNs resected and survival. Overall survival (OS) and disease-free survival (DFS) curves were calculated according to the Kaplan–Meier method and log-rank analysis. Multivariate analysis (MVA) was performed by the Cox proportional hazard model.
Results
We identified 358 patients with a mean follow-up of 27.3 months. The number of LN removed was not impacted by the type of surgical procedure. The number of LNs removed (<10 vs. ≥10, <12 vs. ≥12, and <15 vs. ≥15) did not impact OS or DFS. We found a significant difference in OS and DFS by pathologic response. The median and 5-year OS for patients with complete, partial, and no response was 65.6 months and 52.7 %, 29.7 months and 30.4 %, and 17.7 months and 25.4 % (
p
= 0.0002). However, the number of LN harvested did not impact OS and DFS when patients were stratified by pathologic response. MVA also revealed that the number of lymph nodes removed was not prognostic for OS or DFS. Higher age, higher stage, and less than a complete response were associated with a decreased OS. Higher stage and less than a complete response were prognostic for worse DFS.
Conclusions
The number of LNs harvested during esophagectomy does not impact survival after nCRT. Stage and pathologic response continue to be the strongest prognostic factors for survival in esophageal cancer after nCRT.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-013-2988-4</identifier><identifier>PMID: 23625142</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - therapy ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Carcinoma, Squamous Cell - mortality ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - therapy ; Chemoradiotherapy - mortality ; Cisplatin - administration & dosage ; Combined Modality Therapy ; Esophageal Neoplasms - mortality ; Esophageal Neoplasms - pathology ; Esophageal Neoplasms - therapy ; Esophagectomy ; Female ; Fluorouracil - administration & dosage ; Follow-Up Studies ; Humans ; Lymph Node Excision - mortality ; Lymph Nodes - pathology ; Lymph Nodes - surgery ; Lymphatic Metastasis ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate Analysis ; Neoadjuvant Therapy - mortality ; Neoplasm Staging ; Oncology ; Organoplatinum Compounds - administration & dosage ; Paclitaxel - administration & dosage ; Prognosis ; Surgery ; Surgical Oncology ; Survival Rate ; Thoracic Oncology</subject><ispartof>Annals of surgical oncology, 2013-09, Vol.20 (9), p.3038-3043</ispartof><rights>Society of Surgical Oncology 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-p282t-502b76f4026c7c4889a133a081691a44c42704af15369d868041b55a3eeea7513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-013-2988-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-013-2988-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23625142$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shridhar, Ravi</creatorcontrib><creatorcontrib>Hoffe, Sarah E.</creatorcontrib><creatorcontrib>Almhanna, Khaldoun</creatorcontrib><creatorcontrib>Weber, Jill M.</creatorcontrib><creatorcontrib>Chuong, Michael D.</creatorcontrib><creatorcontrib>Karl, Richard C.</creatorcontrib><creatorcontrib>Meredith, Kenneth</creatorcontrib><title>Lymph Node Harvest in Esophageal Cancer After Neoadjuvant Chemoradiotherapy</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
This study was designed to determine the effects of lymph node (LN) harvest on survival in esophageal cancer after neoadjuvant chemoradiation (nCRT).
Methods
An analysis of surgically resected esophageal cancer patients after nCRT was performed to determine an association between the number of LNs resected and survival. Overall survival (OS) and disease-free survival (DFS) curves were calculated according to the Kaplan–Meier method and log-rank analysis. Multivariate analysis (MVA) was performed by the Cox proportional hazard model.
Results
We identified 358 patients with a mean follow-up of 27.3 months. The number of LN removed was not impacted by the type of surgical procedure. The number of LNs removed (<10 vs. ≥10, <12 vs. ≥12, and <15 vs. ≥15) did not impact OS or DFS. We found a significant difference in OS and DFS by pathologic response. The median and 5-year OS for patients with complete, partial, and no response was 65.6 months and 52.7 %, 29.7 months and 30.4 %, and 17.7 months and 25.4 % (
p
= 0.0002). However, the number of LN harvested did not impact OS and DFS when patients were stratified by pathologic response. MVA also revealed that the number of lymph nodes removed was not prognostic for OS or DFS. Higher age, higher stage, and less than a complete response were associated with a decreased OS. Higher stage and less than a complete response were prognostic for worse DFS.
Conclusions
The number of LNs harvested during esophagectomy does not impact survival after nCRT. Stage and pathologic response continue to be the strongest prognostic factors for survival in esophageal cancer after nCRT.</description><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Carcinoma, Squamous Cell - mortality</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - therapy</subject><subject>Chemoradiotherapy - mortality</subject><subject>Cisplatin - administration & dosage</subject><subject>Combined Modality Therapy</subject><subject>Esophageal Neoplasms - mortality</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophageal Neoplasms - therapy</subject><subject>Esophagectomy</subject><subject>Female</subject><subject>Fluorouracil - administration & dosage</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Lymph Node Excision - mortality</subject><subject>Lymph Nodes - pathology</subject><subject>Lymph Nodes - surgery</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neoadjuvant Therapy - mortality</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Organoplatinum Compounds - administration & dosage</subject><subject>Paclitaxel - administration & dosage</subject><subject>Prognosis</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><subject>Thoracic Oncology</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkU1PwzAMhiMEgjH4AVxQJS5cCnHipOkRTcAQ07jAOfLa7EvrB0mLtH9PxoaEuNiW_ch67ZexK-B3IFDdB-AoMeUgU5Ebk-IRG4CKHdQGjmPNtUlzodUZOw9hzTlkkqtTdiakFgpQDNjrZFu1y2TalC4Zk_9yoUtWdfIYmnZJC0ebZER14XzyMO9inLqGynX_RXWXjJauajyVq6ZbOk_t9oKdzGkT3OUhD9nH0-P7aJxO3p5fRg-TtBVGdKniYpbpOXKhi6xAY3ICKYkb0DkQYoEi40jzeInOS6MNR5gpRdI5R5kCOWS3-72tbz77qNhWq1C4zYZq1_TBAoIBlOYHvfmHrpve11HdjsqQQ57vqOsD1c8qV9rWryryW_v7pgiIPRDiqF44_2cNtzsv7N4LG72wOy8sym_t2Xbs</recordid><startdate>20130901</startdate><enddate>20130901</enddate><creator>Shridhar, Ravi</creator><creator>Hoffe, Sarah E.</creator><creator>Almhanna, Khaldoun</creator><creator>Weber, Jill M.</creator><creator>Chuong, Michael D.</creator><creator>Karl, Richard C.</creator><creator>Meredith, Kenneth</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20130901</creationdate><title>Lymph Node Harvest in Esophageal Cancer After Neoadjuvant Chemoradiotherapy</title><author>Shridhar, Ravi ; Hoffe, Sarah E. ; Almhanna, Khaldoun ; Weber, Jill M. ; Chuong, Michael D. ; Karl, Richard C. ; Meredith, Kenneth</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p282t-502b76f4026c7c4889a133a081691a44c42704af15369d868041b55a3eeea7513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Carcinoma, Squamous Cell - mortality</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - therapy</topic><topic>Chemoradiotherapy - mortality</topic><topic>Cisplatin - administration & dosage</topic><topic>Combined Modality Therapy</topic><topic>Esophageal Neoplasms - mortality</topic><topic>Esophageal Neoplasms - pathology</topic><topic>Esophageal Neoplasms - therapy</topic><topic>Esophagectomy</topic><topic>Female</topic><topic>Fluorouracil - administration & dosage</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Lymph Node Excision - mortality</topic><topic>Lymph Nodes - pathology</topic><topic>Lymph Nodes - surgery</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neoadjuvant Therapy - mortality</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Organoplatinum Compounds - administration & dosage</topic><topic>Paclitaxel - administration & dosage</topic><topic>Prognosis</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><topic>Thoracic Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shridhar, Ravi</creatorcontrib><creatorcontrib>Hoffe, Sarah E.</creatorcontrib><creatorcontrib>Almhanna, Khaldoun</creatorcontrib><creatorcontrib>Weber, Jill M.</creatorcontrib><creatorcontrib>Chuong, Michael D.</creatorcontrib><creatorcontrib>Karl, Richard C.</creatorcontrib><creatorcontrib>Meredith, Kenneth</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shridhar, Ravi</au><au>Hoffe, Sarah E.</au><au>Almhanna, Khaldoun</au><au>Weber, Jill M.</au><au>Chuong, Michael D.</au><au>Karl, Richard C.</au><au>Meredith, Kenneth</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lymph Node Harvest in Esophageal Cancer After Neoadjuvant Chemoradiotherapy</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2013-09-01</date><risdate>2013</risdate><volume>20</volume><issue>9</issue><spage>3038</spage><epage>3043</epage><pages>3038-3043</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
This study was designed to determine the effects of lymph node (LN) harvest on survival in esophageal cancer after neoadjuvant chemoradiation (nCRT).
Methods
An analysis of surgically resected esophageal cancer patients after nCRT was performed to determine an association between the number of LNs resected and survival. Overall survival (OS) and disease-free survival (DFS) curves were calculated according to the Kaplan–Meier method and log-rank analysis. Multivariate analysis (MVA) was performed by the Cox proportional hazard model.
Results
We identified 358 patients with a mean follow-up of 27.3 months. The number of LN removed was not impacted by the type of surgical procedure. The number of LNs removed (<10 vs. ≥10, <12 vs. ≥12, and <15 vs. ≥15) did not impact OS or DFS. We found a significant difference in OS and DFS by pathologic response. The median and 5-year OS for patients with complete, partial, and no response was 65.6 months and 52.7 %, 29.7 months and 30.4 %, and 17.7 months and 25.4 % (
p
= 0.0002). However, the number of LN harvested did not impact OS and DFS when patients were stratified by pathologic response. MVA also revealed that the number of lymph nodes removed was not prognostic for OS or DFS. Higher age, higher stage, and less than a complete response were associated with a decreased OS. Higher stage and less than a complete response were prognostic for worse DFS.
Conclusions
The number of LNs harvested during esophagectomy does not impact survival after nCRT. Stage and pathologic response continue to be the strongest prognostic factors for survival in esophageal cancer after nCRT.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>23625142</pmid><doi>10.1245/s10434-013-2988-4</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2013-09, Vol.20 (9), p.3038-3043 |
| issn | 1068-9265 1534-4681 |
| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - therapy Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - therapeutic use Carcinoma, Squamous Cell - mortality Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - therapy Chemoradiotherapy - mortality Cisplatin - administration & dosage Combined Modality Therapy Esophageal Neoplasms - mortality Esophageal Neoplasms - pathology Esophageal Neoplasms - therapy Esophagectomy Female Fluorouracil - administration & dosage Follow-Up Studies Humans Lymph Node Excision - mortality Lymph Nodes - pathology Lymph Nodes - surgery Lymphatic Metastasis Male Medicine Medicine & Public Health Middle Aged Multivariate Analysis Neoadjuvant Therapy - mortality Neoplasm Staging Oncology Organoplatinum Compounds - administration & dosage Paclitaxel - administration & dosage Prognosis Surgery Surgical Oncology Survival Rate Thoracic Oncology |
| title | Lymph Node Harvest in Esophageal Cancer After Neoadjuvant Chemoradiotherapy |
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