Abstract
Metastasis to the posterior thoracic paraaortic lymph nodes rarely occurs in esophageal cancer, and a treatment strategy has not been established. We treated two cases of esophageal cancer with this type of metastasis; in both cases, we successfully performed surgical resection after neoadjuvant chemotherapy. In case 1, the patient received neoadjuvant chemotherapy, which consisted of docetaxel, cisplatin and 5-fluorouracil, and then underwent dissection of the posterior thoracic paraaortic lymph nodes. The left thoracic approach was used together with subtotal esophagectomy via a right thoracotomy. In case 2, the patient also received neoadjuvant chemotherapy and underwent dissection of the posterior thoracic paraaortic lymph nodes. The left thoracoscopic approach was used together with a subtotal esophagectomy and a right upper and middle pulmonary lobectomy (due to lung cancer) with a right thoracotomy. After 42 and 12 months’ post-surgery, respectively, the patients were doing well without any evidence of recurrence.
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References
Japanese Society for Esophageal Diseases. Guidelines for the clinical and pathologic studies on carcinoma of the esophagus. 11th ed. Tokyo: Kanehara Syuppan; 2015.
Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A, editors. AJCC cancer staging manual. 7th ed. New York: Springer; 2010.
Hatooka S, Abe T, Saito T, Mitsudomi T, Shinoda M. Lymph node metastasis of an esophageal cancer behind the thoracic descending aorta. Esophagus. 2010;7:111–4.
Ninomiya I, Okamoto K, Tsukada T, Saito H, Fushida S, Ikeda H, et al. Thoracoscopic radical esophagectomy and laparoscopic transhiatal lymph node dissection for superficial esophageal cancer associated with lymph node metastases in the dorsal area of the thoracic aorta. Surg Case Rep. 2015;1:25.
Horio T, Ogata S, Tsujimoto H, Akase T, Takahata R, Yaguchi Y, et al. Esophageal cancer initially thought to be accompanied by a solitary metastasis to an intrathoracic paraaortic lymph node. Acta Med Okayama. 2012;66:417–21.
Preston SR, Baker CR, Priest OH, Sudderick RM. Thoracoscopic-assisted four-phase esophagectomy with four-field lymph node dissection for esophageal cancer: case report and description of a new technique. J Laparoendosc Adv Surg Tech A. 2012;22:701–4.
Shimada Y, Kawabe A, Nakajima S, Hata K, Takahashi Y, Kume M, et al. A bilateral thoracic approach for esophageal cancer in the prone position. Surg Today. 2015;45:91–5.
Caplan I. Anatomical review of the lymph nodes of the human mediastinum. Surg Radiol Anat. 1990;12:9–18.
Saito H, Sato T, Miyazaki M. Extramural lymphatic drainage from the thoracic esophagus based on minute cadaveric dissections: fundamentals for the sentinel node navigation surgery for the thoracic esophageal cancers. Surg Radiol Anat. 2007;29:531–42.
Der Adachi B. ductus thoracicus der Japaner. In: Kihara T, editor. Das lymphgeasssystem der Japaner. Tokyo: Kenkyu-sha; 1953. p. 1–83.
Kuge K, Murakami G, Mizobuchi S, Hata Y, Aikou T, Sasaguri S. Submucosal territory of the direct lymphatic drainage system to the thoracic duct in the human esophagus. J thoracic Cardiovasc Surg. 2003;125:1343–9.
Riquet M, Saab M, Le Pimpec Barthes F, Hidden G. Lymphatic drainage of the esophagus in the adult. Surg Radiol Anat. 1993;15:209–11.
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Shishido, Y., Miyata, H., Sugimura, K. et al. Successful resection after neoadjuvant chemotherapy for esophageal cancer with posterior thoracic paraaortic lymph node metastasis: a case report and literature review. Gen Thorac Cardiovasc Surg 65, 542–548 (2017). https://doi.org/10.1007/s11748-017-0802-0
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DOI: https://doi.org/10.1007/s11748-017-0802-0