Postoperative recurrent pattern and the lymph node metastatic stations of the thoracic esophageal squamous cell carcinoma
10.3760/cma.j.issn.1004-4221.2019.09.008
- VernacularTitle: 胸段食管鳞癌术后复发模式及淋巴结复发规律
- Author:
Chunyang LI
1
;
Jing YU
;
Jiuling SHEN
;
Wen OUYANG
;
Yu XU
;
Junhong ZHANG
;
Conghua XIE
Author Information
1. Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
- Publication Type:Journal Article
- Keywords:
Esophageal neoplasm;
Recurrent pattern;
Highest risk volume of recurrence;
Radiotherapy target
- From:
Chinese Journal of Radiation Oncology
2019;28(9):673-676
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate postoperative recurrent pattern of the thoracic esophageal squamous cell carcinoma (TESCC), aiming to provide a basis for the delineation of postoperative radiotherapy volume for TESCC.
Methods:Clinical data of 66 TESCC patients who recurred after the radical esophagectomy in Zhongnan Hospital of Wuhan University from 2011 to 2017 were retrospectively analyzed. According to the AJCC 8th edition-defined classification of esophageal carcinoma, regional lymph node stations 1 to 8M were defined as the upper-middle mediastinum region (UMMR), and stations 8Lo, 9 and 15 were defined as the inferior mediastinum region (IMR), stations 16 to 20 were regarded as the upper abdominal lymph node region (UAR).
Results:Among all 66 patients, 41 cases (62%) experienced loco-regional recurrence alone, 25 cases (38%) presented with distant metastasis alone. A total of 54 patients with 148 lymph node recurred after treatment. The highest risk region of lymph node recurrence was UMMR (118/148, 80%), after that, followed by UAR (24/148, 17%). With regard to 9 cases of UAR, 6 patients had lower TESCC, and 8 patients (89%) were graded as ≥ pathological stage Ⅲ.
Conclusions:The highest risk region of lymph node recurrence is UMMR in TESCC patients undergoing radical esophagectomy, which should be considered as the target volume in postoperative radiotherapy. For patients with lower TESCC ≥ pathological stage Ⅲ, UAR might be the target volume with cautions. Anastomosis and IMR are probably not the routine treatment volumes.
