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Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma

BACKGROUND: This study evaluated the locations of lymph node recurrence and their association with irradiation fields used for radiotherapy after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma. METHODS: Medical records of 96 consecutive p...

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Autores principales: Ikawa, Toshiki, Ishihara, Ryu, Konishi, Koji, Morimoto, Masahiro, Hirata, Takero, Kanayama, Naoyuki, Yamamoto, Sachiko, Matsuura, Noriko, Wada, Kentaro, Hayashi, Kenji, Ogawa, Kazuhiko, Teshima, Teruki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6712456/
https://www.ncbi.nlm.nih.gov/pubmed/31222974
http://dx.doi.org/10.1002/cam4.2365
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author Ikawa, Toshiki
Ishihara, Ryu
Konishi, Koji
Morimoto, Masahiro
Hirata, Takero
Kanayama, Naoyuki
Yamamoto, Sachiko
Matsuura, Noriko
Wada, Kentaro
Hayashi, Kenji
Ogawa, Kazuhiko
Teshima, Teruki
author_facet Ikawa, Toshiki
Ishihara, Ryu
Konishi, Koji
Morimoto, Masahiro
Hirata, Takero
Kanayama, Naoyuki
Yamamoto, Sachiko
Matsuura, Noriko
Wada, Kentaro
Hayashi, Kenji
Ogawa, Kazuhiko
Teshima, Teruki
author_sort Ikawa, Toshiki
collection PubMed
description BACKGROUND: This study evaluated the locations of lymph node recurrence and their association with irradiation fields used for radiotherapy after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma. METHODS: Medical records of 96 consecutive patients with superficial esophageal squamous cell carcinoma who underwent adjuvant chemoradiotherapy following endoscopic resection were reviewed. Computed tomography was used to identify whether nodal recurrences were within the elective nodal irradiation field. The cumulative incidence of recurrence was calculated, accounting for death as a competing risk. Univariate and multivariate analyses identified factors predicting nodal recurrence. RESULTS: The median follow‐up period was 61 months (range: 6‐137 months). Seven patients (7.3%) developed lymph node recurrence only; two patients (2.1%) developed nodal plus local recurrence. Six of the seven cases without local recurrence involved the elective nodal irradiation field, with five cases involving the recurrent nerve lymph nodes. The 5‐year cumulative incidence of lymph node recurrence was higher for T1b tumors with lymphovascular invasion than for T1a tumors with lymphovascular invasion (17.6% vs 6.2%, P = 0.086; HR: 3.74, 95% CI: 0.80‐17.52, P = 0.094) and T1b tumors without lymphovascular invasion (17.6% vs 3.3%, P = 0.031; HR: 6.78, 95% CI: 0.80‐57.63, P = 0.080). CONCLUSIONS: Lymph node recurrence frequently involved the elective nodal irradiation field, with recurrent nerve lymph nodes being common metastasis sites. The high incidence of nodal recurrence for T1b tumors with lymphovascular invasion highlights a need for new strategies for treating this subset of superficial esophageal squamous cell carcinomas.
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spelling pubmed-67124562019-09-04 Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma Ikawa, Toshiki Ishihara, Ryu Konishi, Koji Morimoto, Masahiro Hirata, Takero Kanayama, Naoyuki Yamamoto, Sachiko Matsuura, Noriko Wada, Kentaro Hayashi, Kenji Ogawa, Kazuhiko Teshima, Teruki Cancer Med Clinical Cancer Research BACKGROUND: This study evaluated the locations of lymph node recurrence and their association with irradiation fields used for radiotherapy after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma. METHODS: Medical records of 96 consecutive patients with superficial esophageal squamous cell carcinoma who underwent adjuvant chemoradiotherapy following endoscopic resection were reviewed. Computed tomography was used to identify whether nodal recurrences were within the elective nodal irradiation field. The cumulative incidence of recurrence was calculated, accounting for death as a competing risk. Univariate and multivariate analyses identified factors predicting nodal recurrence. RESULTS: The median follow‐up period was 61 months (range: 6‐137 months). Seven patients (7.3%) developed lymph node recurrence only; two patients (2.1%) developed nodal plus local recurrence. Six of the seven cases without local recurrence involved the elective nodal irradiation field, with five cases involving the recurrent nerve lymph nodes. The 5‐year cumulative incidence of lymph node recurrence was higher for T1b tumors with lymphovascular invasion than for T1a tumors with lymphovascular invasion (17.6% vs 6.2%, P = 0.086; HR: 3.74, 95% CI: 0.80‐17.52, P = 0.094) and T1b tumors without lymphovascular invasion (17.6% vs 3.3%, P = 0.031; HR: 6.78, 95% CI: 0.80‐57.63, P = 0.080). CONCLUSIONS: Lymph node recurrence frequently involved the elective nodal irradiation field, with recurrent nerve lymph nodes being common metastasis sites. The high incidence of nodal recurrence for T1b tumors with lymphovascular invasion highlights a need for new strategies for treating this subset of superficial esophageal squamous cell carcinomas. John Wiley and Sons Inc. 2019-06-20 /pmc/articles/PMC6712456/ /pubmed/31222974 http://dx.doi.org/10.1002/cam4.2365 Text en © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Ikawa, Toshiki
Ishihara, Ryu
Konishi, Koji
Morimoto, Masahiro
Hirata, Takero
Kanayama, Naoyuki
Yamamoto, Sachiko
Matsuura, Noriko
Wada, Kentaro
Hayashi, Kenji
Ogawa, Kazuhiko
Teshima, Teruki
Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma
title Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma
title_full Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma
title_fullStr Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma
title_full_unstemmed Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma
title_short Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma
title_sort failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6712456/
https://www.ncbi.nlm.nih.gov/pubmed/31222974
http://dx.doi.org/10.1002/cam4.2365
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