Prospective analysis of the diagnostic yield of extended en bloc resection for adenocarcinoma of the oesophagus or gastric cardia
Background: The extent of lymph node dissection can affect tumour node metastasis staging. The resulting ‘stage migration’ might hamper stage‐by‐stage comparison between different forms of oesophageal resection. The aim of this study was to assess the diagnostic impact of extended en bloc lymphadene...
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| Veröffentlicht in: | British journal of surgery 2001-05, Vol.88 (5), p.715-719 |
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| container_title | British journal of surgery |
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| creator | Hulscher, J. B. F. Van Sandick, J. W. Offerhaus, G. J. A. Tilanus, H. W. Obertop, H. Van Lanschot, J. J. B. |
| description | Background:
The extent of lymph node dissection can affect tumour node metastasis staging. The resulting ‘stage migration’ might hamper stage‐by‐stage comparison between different forms of oesophageal resection. The aim of this study was to assess the diagnostic impact of extended en bloc lymphadenectomy in staging (adeno)carcinoma of the mid/distal oesophagus or gastric cardia.
Methods:
This was a prospective study of 74 patients (67 men and seven women; median age 63 (range 40–78) years) who underwent extended oesophagectomy between 1994 and 2000.
Results:
A median of 31 (range 15–78) lymph nodes was resected (and identified), with a median of 5 (range 0–31) positive nodes. Twenty‐seven patients (36 per cent) had tumour‐positive nodes in extended fields: 15 patients (20 per cent) in the abdomen and 15 patients (20 per cent) in the mediastinum. Subcarinal nodes were most affected (19 per cent). Extended resection led to tumour upstaging in 17 patients (23 per cent); two patients had isolated positive subcarinal nodes and 15 other tumours became M1a owing to positive nodes near the coeliac axis, hepatic artery or splenic artery. Tumour positivity in paratracheal or aortopulmonary nodes occurred in 8 per cent of patients, without influencing staging.
Conclusion:
Extended en bloc lymphadenectomy altered staging in 17 of 74 patients (23 per cent) with adenocarcinoma of the oesophagus or cardia, mainly into M1a owing to positive coeliac nodes (20 per cent). |
| doi_str_mv | 10.1046/j.1365-2168.2001.01746.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_70830656</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70830656</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4312-15bcae21f06313004098a66de48d52c897590486e2510db79fbc2d59387ac2663</originalsourceid><addsrcrecordid>eNpFkV1v0zAUhi0EYt3gLyBLSNwl-CO2E4kbmGBjmhiwIS4txz7pXNK42ClrL_fP56xdubJ0_LzPkf0ihCkpKank-0VJuRQFo7IuGSG0JFRVstw8Q7PDxXM0I4SognLGj9BxSosMciLYS3REKRekqtQM3X-PIa3Ajv4fYDOYfpt8wqHD4y1g5818CGn0Fm899G6aw2aEwYHDMOC2DxZHSFM8DLgLERsHQ7AmWj-EpXkSBUhhdWvm66yOeG7SGLMzY3nDK_SiM32C1_vzBP368vnm9Ly4vDr7evrxsrAVp6ygorUGGO2I5PkZpCJNbaR0UNVOMFs3SjSkqiUwQYlrVdO1ljnR8FoZy6TkJ-jdzruK4e8a0qiXPlnoezNAWCetSM2JFBP4Zg-u2yU4vYp-aeJWP31aBt7uAZOs6btoBuvTgWuEUkJk6sOOuvM9bP9biJ4q1As9NaWnpvRUoX6sUG_0p4trVrEcL3Zxn0bYHOIm_tFScSX0729n-uf59UXzQ1F9wx8ACpyezQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70830656</pqid></control><display><type>article</type><title>Prospective analysis of the diagnostic yield of extended en bloc resection for adenocarcinoma of the oesophagus or gastric cardia</title><source>MEDLINE</source><source>Oxford University Press Journals Current</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Hulscher, J. B. F. ; Van Sandick, J. W. ; Offerhaus, G. J. A. ; Tilanus, H. W. ; Obertop, H. ; Van Lanschot, J. J. B.</creator><creatorcontrib>Hulscher, J. B. F. ; Van Sandick, J. W. ; Offerhaus, G. J. A. ; Tilanus, H. W. ; Obertop, H. ; Van Lanschot, J. J. B.</creatorcontrib><description>Background:
The extent of lymph node dissection can affect tumour node metastasis staging. The resulting ‘stage migration’ might hamper stage‐by‐stage comparison between different forms of oesophageal resection. The aim of this study was to assess the diagnostic impact of extended en bloc lymphadenectomy in staging (adeno)carcinoma of the mid/distal oesophagus or gastric cardia.
Methods:
This was a prospective study of 74 patients (67 men and seven women; median age 63 (range 40–78) years) who underwent extended oesophagectomy between 1994 and 2000.
Results:
A median of 31 (range 15–78) lymph nodes was resected (and identified), with a median of 5 (range 0–31) positive nodes. Twenty‐seven patients (36 per cent) had tumour‐positive nodes in extended fields: 15 patients (20 per cent) in the abdomen and 15 patients (20 per cent) in the mediastinum. Subcarinal nodes were most affected (19 per cent). Extended resection led to tumour upstaging in 17 patients (23 per cent); two patients had isolated positive subcarinal nodes and 15 other tumours became M1a owing to positive nodes near the coeliac axis, hepatic artery or splenic artery. Tumour positivity in paratracheal or aortopulmonary nodes occurred in 8 per cent of patients, without influencing staging.
Conclusion:
Extended en bloc lymphadenectomy altered staging in 17 of 74 patients (23 per cent) with adenocarcinoma of the oesophagus or cardia, mainly into M1a owing to positive coeliac nodes (20 per cent).</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1046/j.1365-2168.2001.01746.x</identifier><identifier>PMID: 11350447</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>Adenocarcinoma - diagnosis ; Adenocarcinoma - surgery ; Adult ; Aged ; Biological and medical sciences ; Cardia ; Esophageal Neoplasms - diagnosis ; Esophageal Neoplasms - surgery ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Lymph Node Excision - methods ; Lymphatic Metastasis ; Male ; Medical sciences ; Middle Aged ; Stomach Neoplasms - diagnosis ; Stomach Neoplasms - surgery ; Stomach, duodenum, intestine, rectum, anus ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Tumors</subject><ispartof>British journal of surgery, 2001-05, Vol.88 (5), p.715-719</ispartof><rights>2001 British Journal of Surgery Society Ltd</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4312-15bcae21f06313004098a66de48d52c897590486e2510db79fbc2d59387ac2663</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1046%2Fj.1365-2168.2001.01746.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1046%2Fj.1365-2168.2001.01746.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=957755$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11350447$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hulscher, J. B. F.</creatorcontrib><creatorcontrib>Van Sandick, J. W.</creatorcontrib><creatorcontrib>Offerhaus, G. J. A.</creatorcontrib><creatorcontrib>Tilanus, H. W.</creatorcontrib><creatorcontrib>Obertop, H.</creatorcontrib><creatorcontrib>Van Lanschot, J. J. B.</creatorcontrib><title>Prospective analysis of the diagnostic yield of extended en bloc resection for adenocarcinoma of the oesophagus or gastric cardia</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background:
The extent of lymph node dissection can affect tumour node metastasis staging. The resulting ‘stage migration’ might hamper stage‐by‐stage comparison between different forms of oesophageal resection. The aim of this study was to assess the diagnostic impact of extended en bloc lymphadenectomy in staging (adeno)carcinoma of the mid/distal oesophagus or gastric cardia.
Methods:
This was a prospective study of 74 patients (67 men and seven women; median age 63 (range 40–78) years) who underwent extended oesophagectomy between 1994 and 2000.
Results:
A median of 31 (range 15–78) lymph nodes was resected (and identified), with a median of 5 (range 0–31) positive nodes. Twenty‐seven patients (36 per cent) had tumour‐positive nodes in extended fields: 15 patients (20 per cent) in the abdomen and 15 patients (20 per cent) in the mediastinum. Subcarinal nodes were most affected (19 per cent). Extended resection led to tumour upstaging in 17 patients (23 per cent); two patients had isolated positive subcarinal nodes and 15 other tumours became M1a owing to positive nodes near the coeliac axis, hepatic artery or splenic artery. Tumour positivity in paratracheal or aortopulmonary nodes occurred in 8 per cent of patients, without influencing staging.
Conclusion:
Extended en bloc lymphadenectomy altered staging in 17 of 74 patients (23 per cent) with adenocarcinoma of the oesophagus or cardia, mainly into M1a owing to positive coeliac nodes (20 per cent).</description><subject>Adenocarcinoma - diagnosis</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardia</subject><subject>Esophageal Neoplasms - diagnosis</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Lymph Node Excision - methods</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Stomach Neoplasms - diagnosis</subject><subject>Stomach Neoplasms - surgery</subject><subject>Stomach, duodenum, intestine, rectum, anus</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Tumors</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkV1v0zAUhi0EYt3gLyBLSNwl-CO2E4kbmGBjmhiwIS4txz7pXNK42ClrL_fP56xdubJ0_LzPkf0ihCkpKank-0VJuRQFo7IuGSG0JFRVstw8Q7PDxXM0I4SognLGj9BxSosMciLYS3REKRekqtQM3X-PIa3Ajv4fYDOYfpt8wqHD4y1g5818CGn0Fm899G6aw2aEwYHDMOC2DxZHSFM8DLgLERsHQ7AmWj-EpXkSBUhhdWvm66yOeG7SGLMzY3nDK_SiM32C1_vzBP368vnm9Ly4vDr7evrxsrAVp6ygorUGGO2I5PkZpCJNbaR0UNVOMFs3SjSkqiUwQYlrVdO1ljnR8FoZy6TkJ-jdzruK4e8a0qiXPlnoezNAWCetSM2JFBP4Zg-u2yU4vYp-aeJWP31aBt7uAZOs6btoBuvTgWuEUkJk6sOOuvM9bP9biJ4q1As9NaWnpvRUoX6sUG_0p4trVrEcL3Zxn0bYHOIm_tFScSX0729n-uf59UXzQ1F9wx8ACpyezQ</recordid><startdate>20010501</startdate><enddate>20010501</enddate><creator>Hulscher, J. B. F.</creator><creator>Van Sandick, J. W.</creator><creator>Offerhaus, G. J. A.</creator><creator>Tilanus, H. W.</creator><creator>Obertop, H.</creator><creator>Van Lanschot, J. J. B.</creator><general>Blackwell Science Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20010501</creationdate><title>Prospective analysis of the diagnostic yield of extended en bloc resection for adenocarcinoma of the oesophagus or gastric cardia</title><author>Hulscher, J. B. F. ; Van Sandick, J. W. ; Offerhaus, G. J. A. ; Tilanus, H. W. ; Obertop, H. ; Van Lanschot, J. J. B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4312-15bcae21f06313004098a66de48d52c897590486e2510db79fbc2d59387ac2663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adenocarcinoma - diagnosis</topic><topic>Adenocarcinoma - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardia</topic><topic>Esophageal Neoplasms - diagnosis</topic><topic>Esophageal Neoplasms - surgery</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Lymph Node Excision - methods</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Stomach Neoplasms - diagnosis</topic><topic>Stomach Neoplasms - surgery</topic><topic>Stomach, duodenum, intestine, rectum, anus</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hulscher, J. B. F.</creatorcontrib><creatorcontrib>Van Sandick, J. W.</creatorcontrib><creatorcontrib>Offerhaus, G. J. A.</creatorcontrib><creatorcontrib>Tilanus, H. W.</creatorcontrib><creatorcontrib>Obertop, H.</creatorcontrib><creatorcontrib>Van Lanschot, J. J. B.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hulscher, J. B. F.</au><au>Van Sandick, J. W.</au><au>Offerhaus, G. J. A.</au><au>Tilanus, H. W.</au><au>Obertop, H.</au><au>Van Lanschot, J. J. B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective analysis of the diagnostic yield of extended en bloc resection for adenocarcinoma of the oesophagus or gastric cardia</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2001-05-01</date><risdate>2001</risdate><volume>88</volume><issue>5</issue><spage>715</spage><epage>719</epage><pages>715-719</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background:
The extent of lymph node dissection can affect tumour node metastasis staging. The resulting ‘stage migration’ might hamper stage‐by‐stage comparison between different forms of oesophageal resection. The aim of this study was to assess the diagnostic impact of extended en bloc lymphadenectomy in staging (adeno)carcinoma of the mid/distal oesophagus or gastric cardia.
Methods:
This was a prospective study of 74 patients (67 men and seven women; median age 63 (range 40–78) years) who underwent extended oesophagectomy between 1994 and 2000.
Results:
A median of 31 (range 15–78) lymph nodes was resected (and identified), with a median of 5 (range 0–31) positive nodes. Twenty‐seven patients (36 per cent) had tumour‐positive nodes in extended fields: 15 patients (20 per cent) in the abdomen and 15 patients (20 per cent) in the mediastinum. Subcarinal nodes were most affected (19 per cent). Extended resection led to tumour upstaging in 17 patients (23 per cent); two patients had isolated positive subcarinal nodes and 15 other tumours became M1a owing to positive nodes near the coeliac axis, hepatic artery or splenic artery. Tumour positivity in paratracheal or aortopulmonary nodes occurred in 8 per cent of patients, without influencing staging.
Conclusion:
Extended en bloc lymphadenectomy altered staging in 17 of 74 patients (23 per cent) with adenocarcinoma of the oesophagus or cardia, mainly into M1a owing to positive coeliac nodes (20 per cent).</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>11350447</pmid><doi>10.1046/j.1365-2168.2001.01746.x</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adenocarcinoma - diagnosis Adenocarcinoma - surgery Adult Aged Biological and medical sciences Cardia Esophageal Neoplasms - diagnosis Esophageal Neoplasms - surgery Female Gastroenterology. Liver. Pancreas. Abdomen Humans Lymph Node Excision - methods Lymphatic Metastasis Male Medical sciences Middle Aged Stomach Neoplasms - diagnosis Stomach Neoplasms - surgery Stomach, duodenum, intestine, rectum, anus Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Tumors |
| title | Prospective analysis of the diagnostic yield of extended en bloc resection for adenocarcinoma of the oesophagus or gastric cardia |
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