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Lymph Node Metastasis and Recurrences from Esophageal Squamous Cell Carcinoma in Patients with Previous Gastrectomy

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Esophageal cancer patients sometimes have a history of previous gastrectomy. To determine whether we should resect or preserve the remnant stomach, we need to understand the frequency and sites of abdominal lymph node (LN) metastasis from esophageal cancer after gastrectomy.

Patients and Methods

In 46 patients with thoracic esophageal squamous cell carcinoma (ESCC) who had a history of previous gastrectomy due to gastric cancer (n = 20) or benign disease (n = 26), the frequency and sites of any LN metastasis including LN metastasis at surgery and LN recurrence were investigated. The factors associated with abdominal LN metastasis were also examined.

Results

The incidence of metastasis to cervical, mediastinal, and abdominal LNs at surgery was 10.8%, 30.4%, and 30.4%, respectively. The incidence of abdominal LN recurrence was 6.5%. Of 46 patients, 16 patients (34.8%) had any abdominal LN metastasis, including abdominal LN metastasis at surgery or abdominal LN recurrence. There was no significant difference in the incidence of any abdominal LN metastasis between the gastric cancer group and the benign disease group (25.0% vs. 42.3%, p = 0.222). Clinically, nodal status was identified as the only independent factor associated with the occurrence of any abdominal LN metastasis, although neither tumor location nor the reason for gastrectomy was.

Conclusions

The present study showed that the incidence of abdominal LN metastasis from ESCC after gastrectomy was not necessarily low, regardless of the tumor location and the reason for previous gastrectomy. This result suggests that gastrectomy should not be omitted easily in ESCC patients after previous gastrectomy.

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References

  1. Shearman DJ, Arnott SJ, Finlayson ND, Pearson JG. Carcinoma of the oesophagus after gastric surgery. Lancet. 1970;1:581–582.

    Article  CAS  Google Scholar 

  2. Macdonald JB, Waissbluth JG, Langman MJ. Carcinoma of the oesophagus and gastric surgery. Lancet. 1971;1:19–20.

    Article  CAS  Google Scholar 

  3. Maeta M, Koga S, Andachi H, Yoshioka H, Wakatsuki T. Esophageal cancer developed after gastrectomy. Surgery. 1986;99:87–91.

    CAS  PubMed  Google Scholar 

  4. Kato H, Tachimori Y, Watanabe H. Surgical treatment for thoracic esophageal carcinoma in patients after gastrectomy. J Surg Oncol. 1992;51:94–99.

    Article  CAS  Google Scholar 

  5. Kuwano H, Matsuda H, Nagamatsu M, et al. Occurrence of esophageal carcinoma after gastrectomy. J Surg Oncol. 1989;41:77–80.

    Article  CAS  Google Scholar 

  6. Tachibana M, Abe S, Yoshimura H, et al. Squamous cell carcinoma of the esophagus after partial gastrectomy. Dysphagia. 1995;10:49–52.

    Article  CAS  Google Scholar 

  7. Alexandrou A, Davis PA, Law S, et al. Esophageal cancer in patients with a history of distal gastrectomy. Arch Surg. 2002;137:1238–1242.

    Article  Google Scholar 

  8. Wada H, Doki Y, Nishioka K, et al. Clinical outcome of esophageal cancer patients with history of gastrectomy. J Surg Oncol. 2005;89:67–74.

    Article  Google Scholar 

  9. Nakanishi K, Daiko H, Kato F, et al. Efficacy of preserving the residual stomach in esophageal cancer patients with previous gastrectomy. Gen Thorac Cardiovasc Surg. 2019;67:470–478.

    Article  Google Scholar 

  10. Jun W, Wei W, Weibing W, et al. Clinical outcome of using gastric remnant or jejunum or colon conduit in surgery for esophageal carcinoma with previous gastrectomy. J Surg Oncol. 2017;115:729–737.

    Article  Google Scholar 

  11. Poh M, Selber JC, Skoracki R, Walsh GL, Yu P. Technical challenges of total esophageal reconstruction using a supercharged jejunal flap. Ann Surg. 2011;253:1122–1129.

    Article  Google Scholar 

  12. Iwata N, Koike M, Kamei Y, et al. Antethoracic pedicled jejunum reconstruction with the supercharge technique for esophageal cancer. World J Surg. 2012;36:2622–2629.

    Article  Google Scholar 

  13. Blackmon SH, Correa AM, Skoracki R, et al. Supercharged pedicled jejunal interposition for esophageal replacement: a 10-year experience. Ann Thorac Surg. 2012;94:1011–1104.

    Google Scholar 

  14. Shirakawa Y, Naomoto Y, Noma K, et al. Colonic interposition and supercharge for esophageal reconstruction. Langenbecks Arch Surg. 2006;391:19–23.

    Article  Google Scholar 

  15. Klink CD, Binnebösel M, Schneider M, et al. Operative outcome of colon interposition in the treatment of esophageal cancer: a 20-year experience. Surgery. 2010;147:491–496.

    Article  Google Scholar 

  16. Hamai Y, Hihara J, Emi M, Aoki Y, Okada M. Esophageal reconstruction using the terminal ileum and right colon in esophageal cancer surgery. Surg Today. 2012;42:342–350.

    Article  Google Scholar 

  17. Mine S, Udagawa H, Tsutsumi K, et al. Colon interposition after esophagectomy with extended lymphadenectomy for esophageal cancer. Ann Thorac Surg. 2009;88:1647–1653.

    Article  Google Scholar 

  18. Doki Y, Okada K, Miyata H, et al. Long-term and short-term evaluation of esophageal reconstruction using the colon or the jejunum in esophageal cancer patients after gastrectomy. Dis Esophagus. 2008;21:132–138.

    Article  CAS  Google Scholar 

  19. Watanabe M, Mine S, Nishida K, et al. Reconstruction after esophagectomy for esophageal cancer patients with a history of gastrectomy. Gen Thorac Cardiovasc Surg. 2016;64:457–463.

    Article  Google Scholar 

  20. Noguchi Y, Imada T, Abe S, et al. Lymphatic flow of the remnant stomach. Nihon Geka Gakkai Zasshi. 1988;89:852–862.

    CAS  PubMed  Google Scholar 

  21. Miyata H, Sugimura K, Yamasaki M, et al. Clinical impact of the location of lymph node metastases after neoadjuvant chemotherapy for middle and lower thoracic esophageal cancer. Ann Surg Oncol. 2019;26:200–208.

    Article  Google Scholar 

  22. Miyata H, Sugimura K, Motoori M, et al. Clinical implications of conversion surgery after induction therapy for T4b thoracic esophageal squamous cell carcinoma. Ann Surg Oncol. 2019;26:4737–4743.

    Article  Google Scholar 

  23. Tachimori Y, Ozawa S, Numasaki H, et al. Efficacy of lymph node dissection by node zones according to tumor location for esophageal squamous cell carcinoma. Esophagus. 2016;13:1–7.

    Article  Google Scholar 

  24. Udagawa H, Ueno M, Shinohara H, et al. The importance of grouping of lymph node stations and rationale of three-field lymphoadenectomy for thoracic esophageal cancer. J Surg Oncol. 2012;106:742–747.

    Article  Google Scholar 

  25. Miyata H, Yamasaki M, Makino T, et al. Therapeutic value of lymph node dissection for esophageal squamous cell carcinoma after neoadjuvant chemotherapy. J Surg Oncol. 2015;112:60–65.

    Article  Google Scholar 

  26. Yamamoto K, Takiguchi S, Miyata H, et al. Randomized phase II study of clinical effects of ghrelin after esophagectomy with gastric tube reconstruction. Surgery. 2010;148:31–38.

    Article  Google Scholar 

  27. Takiguchi S, Takata A, Murakami K, et al. Clinical application of ghrelin administration for gastric cancer patients undergoing gastrectomy. Gastric Cancer. 2014;17:200–205.

    Article  CAS  Google Scholar 

  28. Miyata H, Sugimura K, Motoori M, et al. Clinical features of metastasis from superficial squamous cell carcinoma of the thoracic esophagus. Surgery. 2019;166:1033–1040.

    Article  Google Scholar 

  29. Akutsu Y, Kato K, Igaki H, et al. The prevalence of overall and initial lymph node metastases in clinical T1N0 thoracic esophageal cancer: from the results of JCOG0502, a prospective multicenter study. Ann Surg. 2016;264:1009–1015.

    Article  Google Scholar 

  30. Schlottmann F, Barbetta A, Mungo B, Lidor AO, Molena D. Identification of the lymphatic drainage pattern of esophageal cancer with near-infrared fluorescent imaging. J Laparoendosc Adv Surg Tech A. 2017;27:268–271.

    Article  Google Scholar 

  31. Hachey KJ, Gilmore DM, Armstrong KW, et al. Safety and feasibility of near-infrared image-guided lymphatic mapping of regional lymph nodes in esophageal cancer. J Thorac Cardiovasc Surg. 2016;152:546–554.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan

    Hiroshi Miyata MD, Keijirou Sugimura MD, Naoki Shinno MD, Hisashi Hara MD, Kazuyoshi Yamamoto MD, Takeshi Omori MD, Naotsugu Haraguchi MD, Junichi Nishimura MD, Masayoshi Yasui MD, Daisaku Yamada MD, Hiroshi Wada MD, Kei Asukai MD, Hidenori Takahashi MD, Masayuki Ohue MD & Masahiko Yano MD

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  1. Hiroshi Miyata MD
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  2. Keijirou Sugimura MD
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Correspondence to Hiroshi Miyata MD.

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Miyata, H., Sugimura, K., Shinno, N. et al. Lymph Node Metastasis and Recurrences from Esophageal Squamous Cell Carcinoma in Patients with Previous Gastrectomy. Ann Surg Oncol 27, 5312–5319 (2020). https://doi.org/10.1245/s10434-020-08734-w

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  • DOI: https://doi.org/10.1245/s10434-020-08734-w

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