scholarly journals Extracapsular lymph node involvement after neoadjuvant chemoradiation in esophageal carcinoma: how to interpret?

2017 ◽  
Vol 9 (12) ◽  
pp. E1143-E1144 ◽  
Author(s):  
Lieven P. Depypere ◽  
Philippe R. Nafteux
Keyword(s):  
Lymph Node ◽  
Esophageal Carcinoma ◽  
Lymph Node Involvement ◽  
Neoadjuvant Chemoradiation ◽  
Node Involvement

Detection of lymph node micrometastases in esophageal carcinoma: Pathology of lymph node involvement

2000 ◽  
Vol 118 (4) ◽  
pp. A1030
Author(s):  
Marcus Feith ◽  
Hubert J. Stein ◽  
James Mueller ◽  
J. Ruediger Siewert
Keyword(s):  
Lymph Node ◽  
Esophageal Carcinoma ◽  
Lymph Node Involvement ◽  
Lymph Node Micrometastases ◽  
Node Involvement

scholarly journals RA09.02: LYMPH NODE RESPONSE AFTER NEOADJUVANT CHEMORADIATION THERAPY FOR ESOPHAGEAL ADENOCARCINOMA: TIME FOR AN APPROPRIATE YPN CLASSIFICATION

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 40-40
Author(s):  
Lieven Depypere ◽  
Gert De Hertogh ◽  
Johnny Moons ◽  
An-Lies Provoost ◽  
Toni Lerut ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Esophageal Adenocarcinoma ◽  
Primary Tumor ◽  
Median Overall Survival ◽  
Lymph Node Involvement ◽  
Neoadjuvant Chemoradiation ◽  
Chemoradiation Therapy ◽  
Node Involvement

Abstract Background Response of the primary tumor and lymph node involvement are the most important prognosticators in resected patients with esophageal adenocarcinoma after neoadjuvant chemoradiation. Response on the primary tumor is well established using T(umor) R(egression) G(rading). However, little is known about the prognostic value of lymph node response in these patients. Methods Hematoxylin-eosin slides of 193 adenocarcinoma patients with clinical suspicion of lymph node involvement (cN+) and treated with neoadjuvant chemoradiation therapy between 2008 and 2015 were all reassessed by a senior pathologist. Lymph node response (LNR) was defined as a combination of central fibrosis and at least one other characteristic such as hemosiderin pigment, acellular mucin pools, foam cells, giant cells or calcifications. Lymph nodes were categorized in four categories: 1° as positive (ypN+) when viable tumor was found according to TNM 8th edition. 2° as negative (ypN0) in absence of any viable tumor. 3° as lymph nodes with signs of LNR (LNR+). 4° as lymph nodes without signs of LNR (LNR-). All patients were grouped according to lymph node positivity and lymph node regression. Multivariate and survival analysis were performed by Cox proportional hazard regression analysis. Results Thirty-four patients were ypN + /LNR + , 60 were ypN + /LNR-, 41 were ypN0/LNR + and 58 were ypN0/LNR-. Median overall survival was respectively 41.0 months, 18.5 months, 31.2 months and 62.9 months. Survival was significantly different between ypN0 groups (P = 0.045) but not between ypN + groups (P = 0.299). Multivariate analysis showed that LNR was an independent prognosticator (P = 0.011). Conclusion In cN + esophageal adenocarcinoma patients treated with neoadjuvant chemoradiation with final pathology being ypN0 after esophagectomy, median overall survival is doubled when no signs of LNR were found suggesting these patients were in fact true N0 and that ypN0/LNR + have a similar prognosis as ypN + /LNR + . Using these four categories of ypN allows for more precise evaluation of the impact of induction therapy. Disclosure All authors have declared no conflicts of interest.

Impact of Extracapsular Lymph Node Involvement After Neoadjuvant Chemoradiation Therapy Followed by Surgery in Carcinoma of the Esophagus

2018 ◽  
Vol 268 (6) ◽  
pp. 1000-1007 ◽  
Author(s):  
Lieven P. Depypere ◽  
Johnny Moons ◽  
Christophe Mariette ◽  
Xavier B. D’Journo ◽  
Pascal A. Thomas ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Involvement ◽  
Neoadjuvant Chemoradiation ◽  
Chemoradiation Therapy ◽  
Carcinoma Of The Esophagus ◽  
Neoadjuvant Chemoradiation Therapy ◽  
Node Involvement

Evaluation of pre-operative clinical finding and per-operative assessment of carcinoma stomach in tertiary settings of Bangladesh

2020 ◽  
Vol 22 (1) ◽  
pp. 43-46
Author(s):  
Mst Jesmen Nahar ◽  
Md Mahiuddin Matubber ◽  
Md Mahbubur Rahman ◽  
Md Mahbubur Rahman ◽  
Syed Muhammad Baqul Billah ◽  
...  
Keyword(s):  
Lymph Node ◽  
Clinical Picture ◽  
Preoperative Evaluation ◽  
Lymph Node Involvement ◽  
Lesion Detection ◽  
Clinical Feature ◽  
P Value ◽  
Operative Finding ◽  
Node Involvement ◽  
Carcinoma Stomach

Background: Carcinoma stomach, a major killer cancer all over the world, is still presenting late in developing countries due to delay in early diagnosis, lack of awareness, infrastructure etc. Objectives: To establish the importance of preoperative evaluation on operability of carcinoma stomach. Methods: Sixty clinically and histopathologically diagnosed ca stomach cases who underwent surgery in department of Bangabandhu Sheikh Mujib Medical University, Dhaka, and Dhaka Medical College Hospital, Dhaka in 2011 were assessed with clinical picture, investigations, preoperative evaluation and peroperative findings were recorded. Z test for proportion was used to assess clinical decision predictability with a p value of :s;0.05 as significant. Results: Male (73.33%) predominant with 2.75:1 male:female ratio was observed. Mobility, fixity and abdominal lymphadenopathy were not well detected through clinical assessment (p=0.001) while ascites, metastasis and Shelf of Slummer were similar in both clinical and operative finding. The endoscopy of upper GIT finding gave a unique picture as the findings were almost same as were found during operation. USG detected a lesser proportion of the clinical condition compared to peroperative condition whereas CT performed better than the USG except for the lesion detection. Though Computed Tomography (CT) detected higher percentage of lesion, metastasis, ascites and lymph node involvement compared to ultrasonogram (USG), it was significantly higher only for lesion detection (p=0.002) and lymph node involvement (p=<0.001). In the similar manner USG assessment of lesion detection (p=<0.001) and lymph node involvement (p=0.003) was significantly low compared to operative finding. When we looked between CT and operative finding only lesion detection was significantly low (p=0.01) indicating CT to be most effective predictor of clinical picture for operative decision. Preoperative plan were mostly not in accordance with peroperative decision except for total gastrectomy. Conclusion: The study indicates weakness in clinical detection and pre-operative plan compared to per-operative finding. Hence combination of clinical feature and investigation tools especially endoscopy of upper GIT combined with CT is recommended to predict a better operative decision. Journal of Surgical Sciences (2018) Vol. 22 (1): 43-46

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