scholarly journals Pattern of Locoregional Recurrence After Radical Surgery in Patients With Esophageal Squamous Cell Carcinoma and The Design of Target Volume of Postoperative Prophylactic Radiotherapy

2020 ◽  
Author(s):  
Xiangnan Qiu ◽  
Shenghua Jing ◽  
Changchen Jiang ◽  
Zetian Shen ◽  
XiXu Zhu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Locoregional Recurrence ◽  
Radical Surgery ◽  
Target Volume ◽  
Lower Segment ◽  
Middle Segment ◽  
Postoperative Adjuvant Chemotherapy ◽  
Upper Abdominal ◽  
Upper Mediastinum ◽  
Prophylactic Radiotherapy

Abstract Objective The study was undertaken to evaluate preferred sites for locoregional recurrence after radical surgery for patients with esophageal squamous cell carcinoma (ESCC) and to confirm the target volume of postoperative prophylactic radiotherapy.Methods 139 patients with locoregional recurrent ESCC after radical esophagectomy without postoperative radiotherapy were registered in this study. The sites of locoregional recurrence for these patients were collected and influence factors of locoregional recurrence were analyzed.Results The 1, 2, and 3-year progression-free survival rates were 48.2%, 18.0% and 8.6%, respectively. Mediastinum lymph node (LN) recurrence (74.2%) was the most frequent site of recurrence, following the anastomotic site (28.1%), supraclavicular LN (19.4%) and abdominal LN (15.1%) (P=0.000). The upper mediastinum (72.7%) was one of the most common recurrence occurred in mediastinal LN. Compared with upper and middle segment of ESCC, lower segment had the highest recurrence rate of upper abdominal LN (P=0.001). The predictive factors of anastomotic recurrence were the stage of pT3 or pT4, presence of nerve or vessel invasion, removed LN NO.≤ 17, presence of invasion or adhesion and without postoperative adjuvant chemotherapy. In addition, the risk factors of abdominal LN recurrence in patients with middle segment ESCC included the stage of pT3 or pT4, smoking history and without postoperative adjuvant chemotherapy.Conclusion For thoracic ESCC, supraclavicular, upper mediastinum, subcarinal LNs and anastomosis should be incorporated within target volume of postoperative prophylactic radiotherapy. Regarding to lower segment ESCC, target volume should include upper abdominal LNs. And it need cautious evaluated about upper abdominal LNs when presence of clinicopathologic factor in middle segment ESCC.

scholarly journals Pattern of Recurrence in 428 Patients With Thoracic Esophageal Squamous Cell Carcinoma After Radical Surgery and Its Implication in Postoperative Radiotherapeutic Clinical Target Volume

2021 ◽  
Vol 11 ◽  
Author(s):  
Tiantian Cui ◽  
Hongjiao Zhang ◽  
Tao Yu ◽  
Yiru Chen ◽  
Chengxin Liu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Clinical Target Volume ◽  
Radical Surgery ◽  
Regional Lymph Node ◽  
Postoperative Radiotherapy ◽  
Target Volume ◽  
Recurrence Patterns

PurposeThis study aimed to analyze the recurrence patterns of thoracic esophageal squamous cell carcinoma (ESCC) after radical surgery, and to understand its implication in the clinical target volume (CTV) design of postoperative radiotherapy (PORT) in patients with ESCC.Methods and materialsA total of 428 recurrent ESCC patients after radical surgery between 2014 and 2018 were included in this study. Recurrence patterns, especially anastomotic and regional lymph node recurrence (LNR), were analyzed. A T-shaped CTV were proposed for PORT and were evaluated whether it could cover most of regional LNR.ResultsThese patients all experienced anastomotic and/or regional LNR. Among the 428 patients, 27 cases (6.3%) had anastomotic recurrence only, and184 cases (43.0%) had LNR only. Those sites with an LNR rate higher than 15% in upper thoracic ESCC were as follows: No.101, No.104R, No.104L, No.106recR, No.106recL, No.106pre, No.106tb, No.107, and No. 109. Those with middle thoracic ESCC were as follows: No.104R, No.104L, 106recR, No.106recL, No.106pre, No.106tb, and No.107. Lastly, individuals with lower thoracic ESCC were as follows: No.104L, 106recR, No.106recL, No. 106pre, No. 106tb, No.107, and abdominal No. 3. The proportion of LNR not included in the proposed T-shaped CTV was 12.5% (1/8), 4.7% (6/128), and 10.4% (5/48) in the upper, middle, and lower thoracic segments, respectively.ConclusionsLNR was the most common type of local-regional recurrence in patients after radical surgery. Supraclavicular, superior and middle mediastinal lymph nodes had the highest recurrence rate, the rate of LNR which was outside T-shaped PORT CTV we proposed was less than 15%.

scholarly journals Effect of different prophylactic therapies on the recurrence pattern of esophageal squamous cell carcinoma after radical surgery

2020 ◽  
Author(s):  
Jin-Jun Ye ◽  
Da-Yong Gu ◽  
Cheng Chen ◽  
Huan-Feng Zhu ◽  
Yi-Qin Zhou ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Esophageal Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Statistical Difference ◽  
Radical Surgery ◽  
Regional Lymph Nodes ◽  
Prophylactic Radiotherapy

Abstract Background To compared the patterns of lymph node recurrence after different prophylactic therapies to identify specific and effective target areas for prophylactic radiotherapy. Methods This retrospective study enrolled patients with recurrence from August 2011 to November 2015, who underwent different prophylactic therapies for esophageal squamous cell carcinoma after radical surgery previously. The patients were divided into unprotected, radiotherapy, chemotherapy, and radiochemotherapy groups. The recurrence patterns between these groups were compared. Results A total of 186 patients who met the above criteria were enrolled. The recurrence ratios of regional lymph nodes were 84.2%, 31.3%, 84.0%, and 48.0% in the unprotected, radiotherapy, chemotherapy, and radiochemotherapy groups, respectively. The recurrence ratio of regional lymph nodes in patients who received radiotherapy was significantly decreased ( P =0.009). The recurrence ratio of superior mediastinal lymph node was significantly lower than those of the chemotherapy and unprotected groups ( P =0.000). The recurrence ratios of the radiotherapy group with and without epigastrium coverage were 4/16 and 4/25, respectively, indicating no statistical difference with those of other groups ( P =0.259). The recurrence ratios with and without the coverage of anastomotic sites were 2/19 and 3/22, respectively, revealing no statistical difference with those of other groups ( P =0.712). Conclusion Prophylactic radiotherapy can significantly reduce the recurrence of regional lymph nodes, especially lymph node recurrence on the superior mediastinum.

scholarly journals Post-Surgery Subcutaneous Seeding of Laryngeal Squamous Cell Carcinoma: A Rare Case

2021 ◽  
pp. 568-572
Author(s):  
Yongquan Jiang ◽  
Wanxin Cao ◽  
Yuanbo Luo ◽  
Ji Xu ◽  
Ying Li ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Head And Neck Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Locoregional Recurrence ◽  
Rare Case ◽  
Laryngeal Squamous Cell Carcinoma ◽  
Primary Lesion ◽  
Lymphogenous Metastasis ◽  
Post Surgery

Laryngeal squamous cell carcinoma (LSCC) is the most common malignant head and neck cancer, with a 40% recurrence rate in the first 3 years after radical treatment. Recurrence of LSCC mostly comprises lymphogenous metastasis, hematogenic metastasis, and locoregional recurrence, while LSCC seeding is rarest: there are only 4 cases reported in PubMed, and none of them is one of subcutaneous seeding. We report a case with post-surgery subcutaneous seeding of LSCC. The final biopsy demonstrated that the subcutaneous seeding of the LSCC was 2 cm away from the primary lesion, with no recurrent foci observed in the larynx and tracheostoma and little relation to the primary lesion. Thus, we drew the conclusion that LSCC surgeries should stick to the principle of the non-tumor technique to prevent subcutaneous seeding.

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