Surgical Outcomes for Cancer at the Gastroesophageal Junction

2012 ◽  
Vol 78 (11) ◽  
pp. 1285-1291 ◽  
Author(s):  
Sohei Matsumoto ◽  
Tomoyoshi Takayama ◽  
Kohei Wakatsuki ◽  
Koji Enomoto ◽  
Tetsuya Tanaka ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Metastases ◽  
Mediastinal Lymph Node ◽  
Gastroesophageal Junction ◽  
Survival Rates ◽  
Additional Treatment ◽  
Preoperative Imaging ◽  
Similar Distribution ◽  
Node Metastases

The aim of this study was to evaluate the clinicopathological characteristics and prognostic factors of cancer at the gastroesophageal junction (GEJ) whose center is situated at a site within 2 cm above and below the junction. This retrospective study included 90 patients with cancer at the GEJ, including 58 with adenocarcinoma (ADC) and 32 with squamous cell carcinoma (SCC). ADC tumors were larger in size than SCC tumors. ADC and SCC at the GEJ showed a similar distribution of the pattern of lymphatic spread. The rate of lower mediastinal lymph node metastasis was approximately 20 per cent, which is similar to the nodes along the celiac artery and the nodes along the common hepatic artery. The overall survival rates were similar between the groups. The presence of five or more lymph node metastases was an independent prognostic factor according to a multivariate analysis. When two or more lymph nodes larger than 10 mm were detected preoperatively, five or more lymph node metastases were proven by histology in most cases. The most frequent sites of recurrence of ADC and SCC were the peritoneum and lymph nodes, respectively. Aggressive additional treatment may be needed if two or more lymph nodes are seen on preoperative imaging.

scholarly journals The Value of Paratracheal Lymphadenectomy in Esophagectomy for Adenocarcinoma of the Esophagus or Gastroesophageal Junction: A Systematic Review of the Literature

2021 ◽  
Author(s):  
Amaia Gantxegi ◽  
B. Feike Kingma ◽  
Jelle P. Ruurda ◽  
Grard A. P. Nieuwenhuijzen ◽  
Misha D. P. Luyer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Mediastinal Lymph Node ◽  
Gastroesophageal Junction ◽  
Transthoracic Esophagectomy ◽  
Mediastinal Lymphadenectomy ◽  
Node Metastases ◽  
Upper Mediastinum ◽  
Mediastinal Lymph Node Metastases

Abstract Background The role of upper mediastinal lymphadenectomy for distal esophageal or gastroesophageal junction (GEJ) adenocarcinomas remains a matter of debate. This systematic review aims to provide a comprehensive overview of evidence on the incidence of nodal metastases in the upper mediastinum following transthoracic esophagectomy for distal esophageal or GEJ adenocarcinoma. Methods A literature search was performed using Medline, Embase and Cochrane databases up to November 2020 to include studies on patients who underwent transthoracic esophagectomy with upper mediastinal lymphadenectomy for distal esophageal and/or GEJ adenocarcinoma. The primary endpoint was the incidence of metastatic nodes in the upper mediastinum based on pathological examination. Secondary endpoints were the definition of upper mediastinal lymphadenectomy, recurrent laryngeal nerve (RLN) palsy rate and survival. Results A total of 17 studies were included and the sample sizes ranged from 10-634 patients. Overall, the median incidence of upper mediastinal lymph node metastases was 10.0% (IQR 4.7-16.7). The incidences of upper mediastinal lymph node metastases were 8.3% in the 7 studies that included patients undergoing primary resection (IQR 2.0-16.6), 4,4% in the 1 study that provided neoadjuvant therapy to the full cohort, and 10.6% in the 9 studies that included patients undergoing esophagectomy either with or without neoadjuvant therapy (IQR 8.9-15.8%). Data on survival and RLN palsy rates were scarce and inconclusive. Conclusions The incidence of upper mediastinal lymph node metastases in distal esophageal adenocarcinoma is up to 10%. Morbidity should be weighed against potential impact on survival.

Outcomes of patients with clinical lymphadenopathy treated with radical prostatectomy.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 106-106
Author(s):  
T. T. Higuchi ◽  
R. H. Breau ◽  
E. C. Umbreit ◽  
E. J. Bergstralh ◽  
L. J. Rangel ◽  
...  
Keyword(s):  
Lymph Node ◽  
Radical Prostatectomy ◽  
Lymph Nodes ◽  
Surgical Therapy ◽  
Lymph Node Metastases ◽  
Preoperative Imaging ◽  
Risk Of Death ◽  
Radiology Reports ◽  
Increased Risk ◽  
Node Metastases

106 Background: Some patients with lymph node metastases experience prolonged survival following radical prostatectomy. The purpose of this study was to determine the outcome of patients with clinically suspicious lymph nodes on preoperative imaging who underwent radical prostatectomy and lymphadenectomy. Methods: Patients with lymph node metastases diagnosed during radical prostatectomy from 1988-2003 were reviewed. Patients with preoperative CT or MRI images were included in the study. Radiology reports were reviewed to determine if patients had clinically suspicious lymphadenopathy (cN+). For all analyses, patients with cN+ were compared to those with clinically negative nodes (cN−). Results: Preoperative imaging was available in 202 men with lymph node metastasis at the time of prostatectomy. Of these 17% (34/202) were cN+. None had pre-operative lymph node biopsy and none had abandoned prostatectomy. At a median follow-up of 11.1 years, PSA recurrence occurred in 50% (17/34) and 49% (82/186), local recurrence in 18% (6/34) and 13% (22/186) and systemic progression in 32% (11/34) and 24% (40/186) of patients with cN+ and cN-, respectively. On multivariate analysis, cN+ was not associated with increased risk of death (HR 1.66, p=0.1). Conclusions: cN+ patients undergoing surgical therapy for prostate cancer may experience similar outcomes to cN− patients. The presence of clinically suspicious lymph nodes on preoperative imaging should not be an absolute contraindication for surgical therapy. No significant financial relationships to disclose.

Assessment of cervical lymph node metastases using indirect computed tomography lymphography with iopamidol in a tongue VX2 carcinoma model

2011 ◽  
Vol 125 (8) ◽  
pp. 820-828 ◽  
Author(s):  
Y Shu ◽  
X Xu ◽  
Z Wang ◽  
W Dai ◽  
Y Zhang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Metastases ◽  
Cervical Lymph Node ◽  
Cervical Lymph Nodes ◽  
Cervical Lymph Node Metastases ◽  
Computed Tomography Images ◽  
Vx2 Carcinoma ◽  
Node Metastases

AbstractObjective:To investigate the performance of indirect computed tomography lymphography with iopamidol for detecting cervical lymph node metastases in a tongue VX2 carcinoma model.Materials and methods:A metastatic cervical lymph node model was created by implanting VX2 carcinoma suspension into the tongue submucosa of 21 rabbits. Computed tomography images were obtained 1, 3, 5, 10, 15 and 20 minutes after iopamidol injection, on days 11, 14, 21 (six rabbits each) and 28 (three rabbits) after carcinoma transplantation. Computed tomography lymphography was performed, and lymph node filling defects and enhancement characteristics evaluated.Results:Indirect computed tomography lymphography revealed bilateral enhancement of cervical lymph nodes in all animals, except for one animal imaged on day 28. There was significantly slower evacuation of contrast in metastatic than non-metastatic nodes. A total of 41 enhanced lymph nodes displayed an oval or round shape, or local filling defects. One lymph node with an oval shape was metastatic (one of 11, 9.1 per cent), while 21 nodes with filling defects were metastatic (21/30, 70 per cent). The sensitivity, specificity, accuracy, and positive and negative predictive values when using a filling defect diameter of 1.5 mm as a diagnostic criterion were 86.4, 78.9, 82.9, 82.6 and 83.3 per cent, respectively.Conclusion:When using indirect computed tomography lymphography to detect metastatic lymph nodes, filling defects and slow evacuation of contrast agent are important diagnostic features.

Pre-surgical assessment of mediastinal lymph node metastases in Stage IA non-small-cell lung cancers

2020 ◽  
Vol 68 ◽  
pp. 61-67
Author(s):  
Yong Wang ◽  
Yeqing Zhu ◽  
Rowena Yip ◽  
Dong-Seok Lee ◽  
Raja M. Flores ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastases ◽  
Mediastinal Lymph Node ◽  
Small Cell ◽  
Small Cell Lung ◽  
Lung Cancers ◽  
Stage Ia ◽  
Node Metastases ◽  
Mediastinal Lymph Node Metastases

scholarly journals COL16A1 is differentially expressed in lymph node metastasis in human breast cancer.

2021 ◽  
Author(s):  
Shahan Mamoor
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Metastases ◽  
Metastatic Breast ◽  
Lymphoid Organ ◽  
Primary Tumors ◽  
Node Metastases ◽  
The Brain

Metastasis to the brain is a clinical problem in patients with breast cancer (1-3). Between the breast and the brain reside the secondary lymphoid organ, the lymph nodes. We mined published microarray data (4, 5) to compare primary and metastatic tumor transcriptomes for the discovery of genes associated with metastasis to the lymph nodes in humans with metastatic breast cancer. We found that collagen type XVI alpha 1 chain, COL16A1, was among the genes whose expression was most different in the lymph node metastases of patients with metastatic breast cancer as compared to primary tumors of the breast. COL16A1 mRNA was present at decreased quantities in lymph node metastases as compared to primary tumors of the breast. Importantly, expression of COL16A1 in primary tumors of the breast was correlated with patient overall survival, in lymph node negative patients but not in lymph node positive patients. Modulation of COL16A1 expression may be relevant to the biology by which tumor cells metastasize from the breast to the lymph nodes and the brain in humans with metastatic breast cancer.

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