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Oncologic Outcomes According to Remnant Lymph Node Metastases in Pathologic T0 (ypT0) Esophageal Squamous Cell Carcinoma Following Prospective Neoadjuvant Therapy and Surgery

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

Abstract

Background

Some esophageal cancer patients may have residual nodal metastases following pathologic complete response (pCR) of the primary tumor after neoadjuvant chemoradiotherapy (CRT). This study examines the prognosis according to lymph node metastases in pathologic T0 patients who received neoadjuvant CRT followed by surgery for esophageal squamous cell carcinoma (SCC).

Methods

Prospectively-collected data from patients who underwent protocol-based esophageal resection and reconstruction after neoadjuvant CRT for esophageal SCC from 2000 to 2010 at the Asan Medical Center, Seoul, Korea, were retrospectively studied. Overall survival (OS), recurrence-free survival (RFS), and risk factors for ypT0N1 were analyzed and compared with ypT0N0.

Results

A total of 211 patients underwent prospective, protocol-based esophageal resection and reconstruction after neoadjuvant CRT for esophageal SCC. Of these, 123 patients had a pCR of the primary tumor and were enrolled in this study. Lymph node status was ypT0N0 in 103 patients and ypT0N1 in 20 patients. The two groups did not show significant differences in sex, initial clinical stage, tumor location, and histologic grade. Recurrence occurred in 13 patients (12.6 %) with ypT0N0 and six patients (30.0 %) with ypT0N1, respectively (p = 0.083). Five-year OS and RFS of ypT0N1 were 42.8 ± 13.9 and 41.7 ± 12.8 %, respectively. Survival was compared between the two groups using a log-rank test, and there were no significant differences for OS or RFS.

Conclusions

Residual lymph node metastases did not significantly influence prognosis in pathologic T0 patients who received neoadjuvant CRT followed by surgery for esophageal SCC.

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Acknowledgment

None.

Disclosures

Hyun Jin Cho, Yong-Hee Kim, Hyeong Ryul Kim, Dong Kwan Kim, Seung-Il Park, Jong Hoon Kim, and Sung-Bae Kim declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Incheon, Korea

    Hyun Jin Cho MD

  2. Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Yong-Hee Kim MD, PhD, Hyeong Ryul Kim MD, PhD, Dong Kwan Kim MD, PhD & Seung-Il Park MD, PhD

  3. Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Jong Hoon Kim MD, PhD

  4. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Sung-Bae Kim MD, PhD

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  1. Hyun Jin Cho MD
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  2. Yong-Hee Kim MD, PhD
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  3. Hyeong Ryul Kim MD, PhD
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  4. Dong Kwan Kim MD, PhD
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  5. Seung-Il Park MD, PhD
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  6. Jong Hoon Kim MD, PhD
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  7. Sung-Bae Kim MD, PhD
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Correspondence to Yong-Hee Kim MD, PhD.

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Cho, H.J., Kim, YH., Kim, H.R. et al. Oncologic Outcomes According to Remnant Lymph Node Metastases in Pathologic T0 (ypT0) Esophageal Squamous Cell Carcinoma Following Prospective Neoadjuvant Therapy and Surgery. Ann Surg Oncol 22, 1851–1857 (2015). https://doi.org/10.1245/s10434-014-4195-3

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  • DOI: https://doi.org/10.1245/s10434-014-4195-3

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