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Preoperative assessment of cervical lymph node involvement in esophageal cancer

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Abstract

Lymphoscintigraphy (LS) and computed tomography (CT) were used preoperatively to assess nodal involvement in 23 patients with esophageal cancer. LS predicted nodal involvement with a high sensitivity and low specificity since false positives were frequent while in contrast, CT predicted it with high specificity and low sensitivity. The combination of LS and CT improved sensitivity by up to 87 per cent but not specificity. The positive image of nodes in LS was associated with malignant cell involvement and/or reactive changes in the nodes, especially sinus histiocytosis and germinal center hyperplasia. When cervical nodes were involved, bilateral images of lymph flows were often lost and by using the images of lymph flow as well as those of the nodes, the combination predicted cervical nodal involvement with a sensitivity of 83 per cent and a specificity of 86 per cent. Thus, the combination of LS and CT is beneficial for preoperatively estimating cervical nodal involvement in esophageal cancer.

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References

  1. Sons HU, Bochard F. Esophageal cancer: Autopsy findings in 171 cases. Arch Pathol Lab Med 1984; 108: 983–988.

    PubMed  CAS  Google Scholar 

  2. Postlethwait PW, Sealy WC. Surgery of the esophagus. New York: Appleton-Century-Crofts 1979: 355–358.

    Google Scholar 

  3. Iizuka T, Hirata K, Watanabe H, Semba T. Factors controlling five-year survival in patients with esophageal carcinoma. Jpn J Clin Oncol 1979; 9: 41–48.

    Google Scholar 

  4. Nishihira T, Watanabe T, Ohmori N, Kitamura M, Toyoda T, Hirayama K, Kawachi S, Kumamoto J, Kanoh T, Akaishi T, Sekine Y, Kasai M. Long-term evaluation of patients treated by radical operation for carcinoma of the thoracic esophagus. World J Surg 1984; 8: 778–785.

    Article  PubMed  CAS  Google Scholar 

  5. Giuli R, Sancho-Garnier H. Diagnostic, therapeutic, and prognostic features of cancer of the esophagus: Results of international prospective study conducted by the OESO group (790 patients). Surgery 1986; 99: 614–622.

    PubMed  CAS  Google Scholar 

  6. Akiyama H, Tsurumaru M, Kawamura T, Yoshimasa O. Principles of surgical treatment for carcinoma of the esophagus: Analysis of lymph node involvement. Ann Surg 1981; 194: 438–446.

    PubMed  CAS  Google Scholar 

  7. Isono K, Onoda S, Okuyama K, Sato H. Recurrence of intrathoracic esophageal cancer. Jpn J Clin Oncol 1985; 15: 49–60.

    PubMed  CAS  Google Scholar 

  8. Mori S, Kitamura M. Carcinoma of the thoracic esophagus: Current problems in the extent of lymph node dissection. Geka Chiryo 1989; 60: 639–644. (in Japanese)

    Google Scholar 

  9. Freeny PC, Marks WM. Adenocarcinoma of the gastroesophageal junction: Barium and CT examination. AJR 1982; 138: 1077–1084.

    PubMed  CAS  Google Scholar 

  10. Picus D, Balfe DM, Koehler RE, Roper CL, Owen JW. Computed tomography in the staging of esophageal carcinoma. Radiology 1983; 146: 433–438.

    PubMed  CAS  Google Scholar 

  11. Lea JW, Prager RL, Bender HW. The questionable role of computed tomography in preoperative staging of esophageal cancer. Ann Thoracic Surg 1984; 38: 479–481.

    Article  Google Scholar 

  12. Salonen O, Kivisaari L, Standertskjold-Nordenstam CG, Somer K, Virkkunen P. Computed tomography in staging of oesophageal carcinoma. Scand J Gastroenterol 1987; 22: 65–68.

    PubMed  CAS  Google Scholar 

  13. Lehr L, Rupp N, Siewert JR. Assessment of resectability of esophageal cancer by computed tomography and magnetic resonance imaging. Surgery 1988; 103: 344–350.

    PubMed  CAS  Google Scholar 

  14. Tio TL, Tygat GN. Endoscopic ultrasonography in assessment of intra- and transmural infiltration of tumours in the oesophagus, stomach and papilla of Vater and in the detection of extraoesophageal lesions. Endoscopy 1984; 16: 203–210.

    Article  PubMed  CAS  Google Scholar 

  15. Sugimachi K, Okudaira Y, Ueo H, Ikeda M, Inokuchi K. Transtracheal mediastinal lymphography for visualization of metastatic lymph nodes in carcinoma of the esophagus. Surg Gynecol Obstet 1982; 154: 34–38.

    PubMed  CAS  Google Scholar 

  16. Ege GN, Cummings BJ. Interstitial radiocolloid ileopelvic lymphoscintigraphy: Technique, anatomy and clinical application. Int J Rad Oncol Biol Phys 1980; 6: 1483–1490.

    CAS  Google Scholar 

  17. Kaplan WD. Iliopelvic lymphoscintigraphy. Sem Nucl Med 1983; 13: 42–53.

    Article  CAS  Google Scholar 

  18. Reasebeck PG, Manktelow A, McArthur AM, Packer SG, Berkeley BB. An evaluation of pelvic lymphoscintigraphy in the staging of colorectal carcinoma. Br J Surg 1984; 71: 936–940.

    Google Scholar 

  19. Japanese Society for Esophageal Diseases. Guidelines for the clinical and pathologic studies on carcinoma of the esophagus. Jpn J Surg 1976; 6: 69.

    Article  PubMed  CAS  Google Scholar 

  20. Nishi M, Hiramatsu Y, Hioki K, Hatano T, Yamamoto M. Pulmonary complications after subtotal esophagectomy. Br J Surg 1988; 75: 527–530.

    PubMed  CAS  Google Scholar 

  21. Fan ST, Lau WY, Yip WC, Poon GP, Yenng C, Lam WK, Wong KK. Prediction of postoperative pulmonary complications in oesophagogastric cancer surgery. Br J Surg 1987; 74: 408–410.

    PubMed  CAS  Google Scholar 

  22. Black MM, Opler SR, Speer FD. Microscopic structure of gastric carcinomas and their regional lymph nodes in relation to survival. Surg Gynec Obstet 1954; 98: 725–734.

    PubMed  CAS  Google Scholar 

  23. Kodama Y, Soejima K, Inokuchi K. Reactive hyperplasia of paracortex and germinal centers of the regional lymph nodes in gastric carcinoma cases as a favorable prognostic indicator. Jpn J Surg 1976; 6: 9–18.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. The First Department of Surgery, Medical College of Oita, 879-56, Oita, Japan

    Takao Saito MD, Akihiko Kuwahara, Kazutoshi Kaketani, Etsuro Hirao, Masaki Miyahara, Katsuhiro Shimoda & Michio Kobayashi

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  1. Takao Saito MD
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  2. Akihiko Kuwahara
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  3. Kazutoshi Kaketani
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  4. Etsuro Hirao
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  5. Masaki Miyahara
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  6. Katsuhiro Shimoda
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  7. Michio Kobayashi
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Saito, T., Kuwahara, A., Kaketani, K. et al. Preoperative assessment of cervical lymph node involvement in esophageal cancer. The Japanese Journal of Surgery 21, 145–153 (1991). https://doi.org/10.1007/BF02470901

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  • DOI: https://doi.org/10.1007/BF02470901

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