Abstract 138P
Background
The extent of lymphadenectomy in esophageal carcinoma (EC) has been subject of debate since several decades. Published literature is lacking in concrete evidence of supracarinal pathological lymph node (LN) involvement in middle and lower third EC, and its impact on oncologic outcomes. We present short-term institutional data for the rate of pathological supracarinal LN positivity in operated cases of EC.
Methods
A prospective study was conducted with ethics approval from April 2017 to August 2018. Patients of mid or lower third EC who were candidates for surgery were included. A supracarinal dissection was carried out separately in all the patients in addition to the standard two-field lymphadanectomy. Harvested nodal stations were labeled individually according to the Japanese Esophageal Classification and sent for histopathological examination. Outcomes were recorded in the postoperative period as well as during follow-up.
Results
Of the 76 patients that underwent an esophagectomy, 73 were squamous cell carcinomas whereas only 3 were adenocarcinomas. 44 (57.9%) of patients were stage II, 22 (28.9%) were stage III, and 7 (9.2%) were stage IB. 44 (57.9%) patients had prior chemoradiation, 9 (11.8%) had neoadjuvant chemotherapy whereas 18 (23.6%) did not receive any therapy prior to surgery. 26 (34.2%) cases were found to have pathological mediastinal nodes, of which supracarinal pathological nodes were found in 20 (26.3%) patients. Pathological supracarinal nodes were found in 16/51 (31.37%) patients with tumors of the middle one-third, and in 4/25 (16%) patients with lower one-third tumors. Average supracarinal LN yield was 10.33 (range- 2-32) nodes. 5 (6.5%) patients had only supracarinal LN positive for malignancy. 5 (6.57%) patients had pulmonary complications, 4 (4.52%) had RLN injury/ permanent hoarseness, and 6 (7.8%) had an anastomotic leak. In-hospital mortality was 4(5.2%).
Conclusions
Extended two field with supracarinal lymphadenectomy is strongly recommended in cases of middle third EC, who have received neoadjuvant treatment, although it should be considered even for lower third or gastroesophageal junction tumors.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
107P - The efficacy of adjuvant chemotherapy according to the risk classification of recurrence based on the systemic inflammatory markers in patients with colorectal cancer liver metastases
Presenter: Masatsune Shibutani
Session: Poster display session
Resources:
Abstract
108P - Influence of liver metastasis locations on overall survival in patients with colorectal cancer
Presenter: Takayuki Sone
Session: Poster display session
Resources:
Abstract
109P - 18F-FDG PET/CT textural features as predictors of outcomes in patients with primary advanced colorectal cancer
Presenter: Jing Yang
Session: Poster display session
Resources:
Abstract
110P - D3 lymph node dissection may be necessary in clinical stage I right colon cancer
Presenter: Woong Bae Ji
Session: Poster display session
Resources:
Abstract
111P - Is preoperative chemoradiotherapy necessary for all patients with upper rectal cancer: One center retrospective study
Presenter: Jasur Madyarov
Session: Poster display session
Resources:
Abstract
112P - A retrospective analysis of the association between perioperative, post adjuvant carcinoembryonic antigen level and prognosis in stage III colorectal cancer
Presenter: Ryotaro Kozuki
Session: Poster display session
Resources:
Abstract
113P - Dicer contributes to chemoresistance in colorectal cancer via regulating a set of miRNAs and their downstream mRNAs
Presenter: Liang-Yi Hung
Session: Poster display session
Resources:
Abstract
114P - Efficacy and safety of the combination of bevacizumab with raltitrexed-based chemotherapy as second-line therapy in patients with metastatic colorectal cancer (mCRC): An interim analysis of a multicenter phase II trial
Presenter: Jun Zhu
Session: Poster display session
Resources:
Abstract
115P - Expression of Ki-67 as a prognostic factor in patients with colorectal cancer
Presenter: Kuantkan Zhabagin
Session: Poster display session
Resources:
Abstract
116P - Clinical significance and converionrate relevance of RAS genetic mutation analysis for unresectable colorectal liver metastases: A single-center retrospective study
Presenter: Meiling Ji
Session: Poster display session
Resources:
Abstract