Supraclavicular and celiac metastases in squamous cell carcinoma of the middle thoracic esophagus
- 59 Downloads
Squamous cell carcinoma of the middle thoracic esophagus (SCC-ME) often metastasizes to the neck, mediastinum, and abdomen. This study aims to assess the prognostic impact of supraclavicular (SC) and celiac (CE) lymph node (LN) metastases in patients with SCC-ME.
We examined 210 patients who underwent curative esophagectomy with three-field LN dissection for SCC-ME. The clinicopathological features and survival outcomes of patients with and without SC and/or CE metastases were compared to assess the prognostic significance of SC and/or CE metastases.
We observed metastases to SC and CE in 25 (11.9%) and 20 (9.5%) patients, respectively. Seven patients (3.3%) had both SC and CE metastases. Although the survival of patients with SC and/or CE metastases was worse compared with those without, that of patients with SC metastases but without CE metastases was comparable with that of patients with CE metastases but without SC metastases; the 5 year overall survival rates were 35.6% and 46.2%, respectively. However, survival of patients with both SC and CE metastases was the worst among all groups, and all patients with both SC and CE metastases experienced disease recurrence.
The prognosis of patients with both SC and CE metastases was extremely poor. In contrast, patients with metastasis to either one of these sites could be candidates for surgery as the main modality in a multidisciplinary strategy.
KeywordsEsophageal squamous cell carcinoma Lymph node metastasis Supraclavicular metastasis Celiac metastasis Prognosis
Study conception and design: all authors. Acquisition of data: all authors. Analysis and interpretation of data: Okamura, Watanabe, and Mine. Drafting of manuscript: Okamura, Watanabe, and Mine. Critical revision of manuscript: all authors.
Compliance with ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. This article does not contain any studies with animals performed by any of the authors.
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Kuwano H, Nishimura Y, Oyama T, Kato H, Kitagawa Y, Kusano M, Shimada H, Takiuchi H, Toh Y, Doki Y, Naomoto Y, Matsubara H, Miyazaki T, Muto M, Yanagisawa A (2015) Guidelines for diagnosis and treatment of carcinoma of the esophagus april 2012 edited by the Japan esophageal society. Esophagus 12:1–30CrossRefGoogle Scholar
- 2.Brierley JD, Gospodarowicz MK, Wittekind C (2017) TNM classification of malignant tumors. Wiley, EnglandGoogle Scholar
- 4.Frizzell B, Sinha D, Williams T, Reed CE, Sherman CA, Turrisi A (2003) Influence of celiac axis lymph nodes in the definitive treatment of esophageal cancer. Am J Clin Oncol 26:215–220Google Scholar
- 8.Ma X, Li B, Yang S et al (2014) Extent of lymph node dissection: common hepatic artery lymph node dissection can be omitted for esophageal squamous cell carcinoma. J Thorac Dis 6:S325–S332Google Scholar
- 9.Tachimori Y, Ozawa S, Numasaki H, Matsubara H, Shinoda M, Toh Y, Udagawa H, Registration Committee for Esophageal Cancer of the Japan Esophageal Society (2014) Supraclavicular node metastasis from thoracic esophageal carcinoma: a surgical series from a Japanese multi-institutional nationwide registry of esophageal cancer. J Thorac Cardiovasc Surg 148:1224–1229CrossRefGoogle Scholar
- 10.Yamasaki M, Miyata H, Miyazaki Y, Takahashi T, Kurokawa Y, Nakajima K, Takiguchi S, Mori M, Doki Y (2014) Evaluation of the nodal status in the 7th edition of the UICC-TNM classification for esophageal squamous cell carcinoma: proposed modifications for improved survival stratification: impact of lymph node metastases on overall survival after esophagectomy. Ann Surg Oncol 21:2850–2856CrossRefGoogle Scholar
- 13.Cho WK, Oh D, Ahn YC, Shim YM, Zo JI, Sun JM, Ahn MJ, Park K (2017) Supraclavicular and/or celiac lymph node metastases from thoracic esophageal squamous cell carcinoma did not compromise survival following neoadjuvant chemoradiotherapy and surgery. Oncotarget 8:3542–3552Google Scholar
- 14.Honma Y, Hokamura N, Nagashima K, Sudo K, Shoji H, Iwasa S, Takashima A, Kato K, Hamaguchi T, Boku N, Umezawa R, Ito Y, Itami J, Koyanagi K, Igaki H, Tachimori Y (2017) Clinical outcomes of resectable esophageal cancer with supraclavicular lymph node metastases treated with curative intent. Anticancer Res 37:3741–3749Google Scholar
- 21.Ando N, Iizuka T, Ide H, Ishida K, Shinoda M, Nishimaki T, Takiyama W, Watanabe H, Isono K, Aoyama N, Makuuchi H, Tanaka O, Yamana H, Ikeuchi S, Kabuto T, Nagai K, Shimada Y, Kinjo Y, Fukuda H, Japan Clinical Oncology Group (2003) Surgery plus chemotherapy compared with surgery alone for localized squamous cell carcinoma of the thoracic esophagus: a Japan clinical oncology group study–JCOG9204. J Clin Oncol 21:4592–4596CrossRefGoogle Scholar
- 22.Ando N, Kato H, Igaki H, Shinoda M, Ozawa S, Shimizu H, Nakamura T, Yabusaki H, Aoyama N, Kurita A, Ikeda K, Kanda T, Tsujinaka T, Nakamura K, Fukuda H (2012) A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol 19:68–74CrossRefGoogle Scholar