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Neoadjuvant Chemoradiotherapy Followed by Esophagectomy with Three-Field Lymph Node Dissection for Thoracic Esophageal Squamous Cell Carcinoma Patients with Clinical Stage III and with Supraclavicular Lymph Node Metastasis
| Content Provider | MDPI |
|---|---|
| Author | Sato, Yusuke Motoyama, Satoru Wada, Yuki Wakita, Akiyuki Kawakita, Yuta Nagaki, Yushi Terata, Kaori Imai, Kazuhiro Anbai, Akira Hashimoto, Manabu Minamiya, Yoshihiro |
| Copyright Year | 2021 |
| Description | Background: Neoadjuvant chemoradiotherapy (NACRT) followed by esophagectomy is now the standard treatment for patients with resectable advanced thoracic esophageal squamous cell carcinoma (ESCC) worldwide. However, the efficacy of NACRT followed by esophagectomy with three-field lymph node dissection for clinical Stage III patients and for clinical Stage IVB patients with supraclavicular LN metastasis has not yet been determined. Methods: Between 2008 and 2018, 94 ESCC patients diagnosed as clinical Stage III and 18 patients diagnosed as clinical Stage IVB with supraclavicular LN metastasis as the only distant metastatic factor were treated with NACRT followed by esophagectomy with extended lymph node dissection at Akita University Hospital. Long-term survival and the patterns of recurrence in these 112 patients were analyzed. Results: The median follow-up period of censored cases was 60 months. The five-year OS and DSS rates among the clinical Stage III patients were 57.6% and 66.6%, respectively. The five-year OS and DSS rates among the clinical Stage IVB patients were 41.3% and 51.6%, respectively. The most frequent recurrence pattern was distant metastasis (69.2%) in the Stage III patients and LN metastasis (75.0%) in the Stage IVB patients. Conclusion: NACRT followed by esophagectomy with three-field LN dissection is feasible and offers the potential for long-term survival of clinical Stage III ESCC patients and even clinical Stage IVB patients with supraclavicular LN metastasis as the only distant metastatic factor. At least in patients with upper and middle thoracic ESCC, treating supraclavicular LNs as regional LNs seems to be appropriate. |
| Starting Page | 983 |
| e-ISSN | 20726694 |
| DOI | 10.3390/cancers13050983 |
| Journal | Cancers |
| Issue Number | 5 |
| Volume Number | 13 |
| Language | English |
| Publisher | MDPI |
| Publisher Date | 2021-02-26 |
| Access Restriction | Open |
| Subject Keyword | Cancers Surgery Esophageal Cancer Esophageal Squamous Cell Carcinoma Prognosis Neoadjuvant Treatment Chemoradiotherapy Nacrt Three-field Supraclavicular Ln Metastasis |
| Content Type | Text |
| Resource Type | Article |
