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
YO10 - Rectal Follicular Dendritic Cell Sarcoma
Presenter: Kripa Bajaj
Session: Poster display session
Resources:
Abstract
YO11 - Postoperative metastasis prediction based on portal vein circulating tumor cells detected by flow cytometry in periampullary or pancreatic cancer
Presenter: Lianyuan Tao
Session: Poster display session
Resources:
Abstract
YO12 - Case report of Hepatic EBV-associated smooth muscle tumor in AIDS patient
Presenter: Gorawich Kerkarchachai
Session: Poster display session
Resources:
Abstract
YO13 - IgG4-related pseudo-tumor of the kidney and multiple organ involvement mimicked malignancy
Presenter: Wasamol Mahaparn
Session: Poster display session
Resources:
Abstract
YO14 - Urachal Adenocarcinoma: Case Report
Presenter: Michelle Joane Alcantara
Session: Poster display session
Resources:
Abstract
YO15 - Concurrent Atezolizumab-Radiotherapy in Locally Recurrent Urinary Bladder Carcinoma: A Case Report
Presenter: Ma. Angelle Lalaine Dantes
Session: Poster display session
Resources:
Abstract
YO16 - Clear cell RCC with synchronous metastasis at transplanted kidney and bone in patient post Cadaveric donor kidney transplantation
Presenter: Punyaporn Cheewasathianchai
Session: Poster display session
Resources:
Abstract
YO17 - Serous ovarian cancer treated with palbociclib and letrozole
Presenter: Dai Wee Lee
Session: Poster display session
Resources:
Abstract
YO18 - A patient with Peutz-Jegher syndrome who incidentally found sex cord stromal tumor: a case report
Presenter: Pongput Pimsa
Session: Poster display session
Resources:
Abstract
YO19 - A case of CLL/SLL with transdifferentiation to dendritic cell tumor and possibly a hybrid lymphodendritic cell neoplasm:The missing link?
Presenter: Yanping Chen
Session: Poster display session
Resources:
Abstract