scholarly journals Development of a prediction model for the risk of recurrent laryngeal nerve lymph node metastasis in thoracolaparoscopic esophagectomy with cervical anastomosis

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Guoqing Zhang ◽  
Yuanqi Li ◽  
Qian Wang ◽  
Huiwen Zheng ◽  
Lulu Yuan ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Prediction Model ◽  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Cervical Anastomosis ◽  
Node Metastasis

VS01.06: THORACOSCOPIC EXTENDED LYMPHADENECTOMY FOR EGJ CANCER: AN OPTION TO LEARN FROM THE EAST

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 45-45
Author(s):  
Simone Giacopuzzi ◽  
Jacopo Weindelmayer ◽  
Giovanni De Manzoni
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Recurrent Laryngeal Nerve ◽  
Esophagogastric Junction ◽  
Conflicts Of Interest ◽  
Laryngeal Nerve ◽  
Extended Lymphadenectomy ◽  
Node Dissection ◽  
Node Metastasis ◽  
The Right

Abstract Description Extended thoracoscopic lymphadenectomy is not common practice in Western countries in patients with adenocarcinoma of the esophagogastric junction. In this video we present a case of a patient with siewert I adenocarcinoma with lymph node metastasis to the right recurrent laryngeal nerve not treated with neoadjuvant therapy, due to comorbidity. The operation was: extended thoracoscopic en-block lymph node dissection. video will be edited in a more rigorous manner Disclosure All authors have declared no conflicts of interest.

P152 CLINICAL PREDICTIVE MODEL OF LYMPH NODE METASTASIS AT RIGHT RECURRENT LARYNGEAL NERVE ZONE IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Li Zhigang ◽  
Li Baiwei ◽  
Li Bin ◽  
Yang Yang
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Esophageal Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Node Metastasis ◽  
Short Diameter

Abstract Aim The aim of this study is to establish a clinical predictive standard for lymph node metastasis at this location by retrospectively comparing the traditional imaging findings of RRLN lymph nodes in esophageal squamous cell carcinoma with postoperative pathology. Background The right recurrent laryngeal nerve (RRLN) is the zone most prone to lymph node metastasis of esophageal squamous cell carcinoma. Although the survival benefit is large after surgical dissection, however, the postoperative mortality rate is significantly increased if the nerve is injured. How to selectively perform lymph node dissection at this location has always been a clinical problem that needs to be addressed. In the past, clinical evaluations mostly used lymph node short diameter ≥1cm as the diagnostic criteria for metastasis, which significantly underestimated the actual clinical situation. Methods 308 patients with thoracic esophageal squamous cell carcinoma who underwent surgical treatment in Shanghai Chest Hospital from Jan 2018 to Dec 2018 were retrospectively analyzed. According to imaging 1mm layer thickness enhanced CT as a tool, the RRLN lymph node short diameter (ctNd) size was measured. All patients were divided into four groups: (A) CT images without RRLN lymph node, (B) CT images with RRLN lymph node was 0<ctNd<5mm, (C) CT images with RRLN lymph node was 5mm≤ctNd<10mm, (D) CT images with RRLN lymph node was ctNd≥10mm. The RRLN lymph node metastasis of each group was analyzed, and the influencing factors were analyzed to establish a predictive model. Results Among all patients, 87.6% of the patients had lymph nodes detected in the RRLN surgical specimens. The sampling rate was 14.5% (121/832), the RRLN lymph node metastasis rate was 19.48%, and the total lymph node metastasis rate was 48.7%. RRLN lymph nodes (57.1%) (A-132, B-43, C-125, D-9) were seen in the preoperative CT scan of 176 patients. The postoperative pathological RRLN lymph node metastasis rate was 9.1%, 18.6%, 27.2% and 66.7%, respectively (P=0.01). Multivariate analysis showed that ctNd, tumor location and N stage were risk factors for RRLN lymph node metastasis (P<0.05). The risk of upper esophageal cancer metastasis was higher than middle segment esophageal cancer (28.2% vs 18.6%, P<0.05). The higher the risk of right laryngeal lymph node metastasis was detected in the later N stage (cN0-13.2%, cN1-21.5%, cN2-46.7%, P<0.05). The 6.5mm short diameter of RRLN lymph nodes on CT scan is the critical value of metastasis at this position (sensitivity 50%, specificity 83.5%), and the higher the risk of metastasis was seen in the larger the short diameter (P<0.05). Conclusion More than 6.5mm short diameter in the CT scan image should be the clinical predictor of lymph node metastasis of the right recurrent laryngeal nerve. The higher risk of metastasis was seen in the greater short diameter. Upper esophageal cancer and multiple lymph node metastasis increase the risk of RRLN lymph node metastasis. Key words esophageal cancer, lymph node metastasis, recurrent laryngeal nerve, computed tomography

647 THE LEFT AND RIGHT RECURRENT LARYNGEAL NERVE LYMPH NODES POSSESS DIFFERENT ANATOMICAL CHARACTERISTICS AND RISK STRATIFICATIONS OF METASTASIS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Guoqing Zhang ◽  
Shanshan Zhao ◽  
Qiyuan Li ◽  
Lulu Yuan ◽  
Gen Gao ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Laryngeal Nerve ◽  
Short Axis ◽  
Cervical Anastomosis ◽  
Anatomical Characteristics ◽  
Node Metastasis ◽  
Preoperative Ct ◽  
Left And Right

Abstract   The left and right recurrent laryngeal nerve(RLN) are asymmetrical, and the precise differences and metastasis risk stratifications based on preoperative CT scan between the left and right RLN lymph nodes have not yet been analyzed. In this study, we compared the anatomical characteristics and generated prediction models to predict the probability of left and right RLN lymph node metastasis using preoperative clinical data in patients undergoing thoracolaparoscopic esophagectomy with cervical anastomosis to guide clinical treatment. Methods We retrospectively reviewed the clinical data of 1660 consecutive patients with thoracic esophageal cancer who underwent esophagectomy with cervical anastomosis at the Department of Thoracic Surgery at our center between January 2015 and December 2020 and investigated the anatomical characteristics and risks of bilateral RLN lymph nodes according to preoperative CT scan and pathological examination findings. Results A total of 299 and 343 patients who underwent left(right) RLN lymph node dissection were included in the final analysis. By plotting ROC curves, we concluded that the cutoff values of the long and short axis to predict metastasis of the left (right) RLN lymph nodes were 10 (8 mm) and 7.5 (6.5 mm), respectively. The short axis rather than the long axis was significantly associated with left RLN lymph node metastasis. Correspondingly, the long axis was much more important than the short axis in regard to the right RLN lymph nodes. Conclusion There were different anatomical characteristics and precise metastasis risk stratifications between the left and right RLN lymph node metastases.

scholarly journals A NOVEL SCORING SYSTEM FOR RISK OF PAPILLARY THYROID CANCER METASTASES IN LYMPH NODES POSTERIOR TO THE RIGHT OF THE RECURRENT LARYNGEAL NERVE

2020 ◽  
Author(s):  
Jianbo Li ◽  
Gaofei He ◽  
Yifan Tong ◽  
Li Tao ◽  
Lei Xie ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Recurrent Laryngeal Nerve ◽  
Scoring System ◽  
Central Compartment ◽  
Laryngeal Nerve ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
The Right ◽  
Development And Validation

Background: Papillary thyroid carcinoma (PTC) can frequently metastasize to the cervical lymph node, especially in the central compartment. Some surgeons believe that dissection posterior to the right recurrent laryngeal nerve lymph node (PRRLN-LN) is unnecessary because of the low metastasis rate and high complication risk. However, persistent metastatic lymph nodes may have a higher recurrence rate, surgical risk, and complications. Thus, it is important to distinguish patients who require PRRLN-LN dissection. The aim of this study was to identify the risk factors for PRRLN-LN metastasis (LN-prRLN), and to establish a scoring system, to help determine whether PRRLN-LN dissection is required in PTC patients. Methods: The study comprised 821 patients with primary PTC in the right or both lobes who had undergone right lobectomy or total thyroidectomy with only right, or bilateral central compartment dissection with/without lateral neck dissection, between January 2010 and June 2016 in our institution. Participants were randomly allocated to development and validation cohorts in a 2:1 ratio. A nomogram-based predictive model for LN-prRLN was established based on the risk factors identified in the development cohort. Results: LN-prRLN was diagnosed pathologically in 15.1% (124/821) of patients from the entire cohort. Multivariate analysis identified age (odds ratio [OR] 0.964, 95% confidence interval [CI] 0.945–0.983; P<0.001), tumor size (OR 1.536, 95%CI 1.135–2.079; P=0.005), extrathyroidal extension (OR 2.271, 95%CI 1.368–3.770; P=0.002), clinically-involved right central compartment lymph node metastasis (OR 1.643, 95%CI 1.055–2.559; P=0.028), and right lateral lymph node metastasis (OR 4.271, 95%CI 2.325–7.844; P<0.001) as predictors of LN-prRLN. A risk model was established and well validated. Calibration curves to evaluate the nomogram in both the development and validation cohorts revealed a C-index of 0.756±0.058 and 0.745±0.042, respectively. Conclusions: Our scoring system may be useful for helping surgeons to decide which patients should undergo dissection of the PRRLN-LN. Abbreviations: ATA = American Thyroid Association; CCD = Central compartment dissection; CI = Confidence interval; C-index = The concordance index; ETE = Extrathyroidal extension; FNA = Fine-needle aspiration; LNM = Lymph node metastasis; LN-prRLN = Posterior to the right recurrent laryngeal nerve lymph node metastasis; OR = Odds ratio; PRRLN-LN = Posterior to the right recurrent laryngeal nerve lymph node; PTC = Papillary thyroid carcinoma; RLN = Recurrent laryngeal nerve.

Sign in / Sign up

Export Citation Format

Share Document