512 OUTCOME OF MULTIMODAL TREATMENT FOR SOLITARY LYMPH NODE RECURRENCE OF ESOPHAGEAL CARCINOMA AFTER CURATIVE RESECTION

Patients with esophageal squamous cell carcinoma (ESCC) often display recurrence in the solitary lymph nodes after surgery. The optimal treatment strategy for these patients has not been established. The aim of the present study was to evaluate the outcome of intensive treatment for recurrent lymph node metastasis retrospectively. Methods Of the 19 patients with solitary recurrent lymph node metastasis after curative esophagectomy between 2006 and 2015, 7 had cervical lymph node, 7 had mediastinal lymph node, and 5 had abdominal lymph node recurrence. Multimodal treatment was performed in the patients: 2 patients underwent lymphadenectomy with adjuvant therapy, and 15 received definitive chemoradiotherapy and repeated chemotherapy. The remaining 2 patients received chemotherapy. Results Survival of lymphadenectomy group tended to be better than that of other groups (p = 0.1388), and survival of the lymphadenectomy and the chemoradiotherapy groups was significantly better than that of the patients who received chemotherapy (p = 0.0209). Partial response (PR), stable disease, and progressive disease were obtained in 8 (53%), 1 (7%), and 6 (40%) patients who received chemoradiotherapy, respectively. Among chemoradiotherapy groups, patients with a therapeutic effect (PR) on radiation therapy had significantly better prognosis (p = 0.0175). Conclusion Multimodal treatment including lymphadenectomy and chemoradiotherapy could improve survival of the patients with solitary lymph node recurrence of esophageal carcinoma after curative resection.

Prognostic significance of solitary lymph node metastasis in patients with stages IA2 to IIA cervical carcinoma

Objective To investigate the prognostic significance of and risk factors for solitary lymph node metastasis (SLNM) of patients with cervical carcinoma. Methods Clinical data from patients with International Federation of Gynecology and Obstetrics (FIGO) stages IA2 to IIA cervical carcinoma who underwent radical hysterectomy and pelvic lymphadenectomy between January 2003 and December 2010 were analysed retrospectively. Histopathological analysis was used to identify SLNM. Long-term survival and risk factors associated with SLNM were analysed. Results The study enrolled 302 patients with cervical cancer: 48 with SLNM (SLNM group) and 254 patients with no lymph node metastases (nLNM group). FIGO stage, tumour grade, depth of tumour invasion, uterine body involvement, parametrial involvement and lymphovascular invasion differed significantly between the two groups. Logistic regression analysis revealed that FIGO stage, depth of tumour invasion and lymphovascular invasion were independent factors associated with SLNM. The 5-year survival rates of the SLNM and nLNM groups were 54.2% and 87.8%, respectively. Multivariate analysis identified SLNM as an independent factor affecting survival. Conclusions The occurrence of just one solitary lymph node metastasis significantly worsened the prognosis in patients with cervical carcinoma compared with patients without lymph node metastases.