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Article: Cervical nodal metastasis from intrathoracic esophageal squamous cell carcinoma is not necessarily an incurable disease

TitleCervical nodal metastasis from intrathoracic esophageal squamous cell carcinoma is not necessarily an incurable disease
Authors
KeywordsCervical lymph node metastases
Chemotherapy
Esophageal carcinoma
Radiotherapy
Surgery
Issue Date2008
PublisherSpringer New York LLC
Citation
Journal Of Gastrointestinal Surgery, 2008, v. 12 n. 10, p. 1638-1645 How to Cite?
AbstractBackground: It remains controversial if metastatic cervical lymph nodes in patients with intrathoracic esophageal cancer signify distant metastases and are therefore incurable or if they should be regarded as regional spread with a potential for cure. Material and Methods: Patients with intrathoracic esophageal squamous cell carcinoma managed from 1995 to 2007, in whom metastatic cervical lymph node spread was confirmed by fine needle aspiration cytology, were studied. Treatment strategies and outcome were reviewed. Results: There were 109 patients, of whom 98 were men. Median age was 62 years (range, 34-88). Excluding those who underwent primarily palliative treatments, there were two main groups: 22 who had upfront chemoradiation therapy and subsequent esophagectomy ± cervical lymphadenectomy and 46 who had chemoradiation only. Significant downstaging occurred in 29 of the 68 patients (42.6%), of whom eight (11.8%) had complete pathological/clinical response. There was no mortality after esophagectomy. Median survival of patients with chemoradiation plus esophagectomy was 34.8 months compared to those with no surgery at 9.9 months, (p<0.001). Patients with stage IV disease at presentation by virtue of nodal disease survived longer than those with the same stage because of systemic organ metastases: 9.3 vs. 3 months, (p<0.001). Conclusions: Prognosis of patients with metastatic cervical nodes was not uniformly dismal. Up to 20% had reasonable survival after chemoradiation and surgical resection. Stage IV disease should be revised to segregate those with nodal and systemic metastases. © 2008 The Society for Surgery of the Alimentary Tract.
Persistent Identifierhttp://hdl.handle.net/10722/58603
ISSN
2015 Impact Factor: 2.807
2015 SCImago Journal Rankings: 1.640
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTong, DKHen_HK
dc.contributor.authorKwong, DLWen_HK
dc.contributor.authorLaw, Sen_HK
dc.contributor.authorWong, KHen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-05-31T03:33:19Z-
dc.date.available2010-05-31T03:33:19Z-
dc.date.issued2008en_HK
dc.identifier.citationJournal Of Gastrointestinal Surgery, 2008, v. 12 n. 10, p. 1638-1645en_HK
dc.identifier.issn1091-255Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/58603-
dc.description.abstractBackground: It remains controversial if metastatic cervical lymph nodes in patients with intrathoracic esophageal cancer signify distant metastases and are therefore incurable or if they should be regarded as regional spread with a potential for cure. Material and Methods: Patients with intrathoracic esophageal squamous cell carcinoma managed from 1995 to 2007, in whom metastatic cervical lymph node spread was confirmed by fine needle aspiration cytology, were studied. Treatment strategies and outcome were reviewed. Results: There were 109 patients, of whom 98 were men. Median age was 62 years (range, 34-88). Excluding those who underwent primarily palliative treatments, there were two main groups: 22 who had upfront chemoradiation therapy and subsequent esophagectomy ± cervical lymphadenectomy and 46 who had chemoradiation only. Significant downstaging occurred in 29 of the 68 patients (42.6%), of whom eight (11.8%) had complete pathological/clinical response. There was no mortality after esophagectomy. Median survival of patients with chemoradiation plus esophagectomy was 34.8 months compared to those with no surgery at 9.9 months, (p<0.001). Patients with stage IV disease at presentation by virtue of nodal disease survived longer than those with the same stage because of systemic organ metastases: 9.3 vs. 3 months, (p<0.001). Conclusions: Prognosis of patients with metastatic cervical nodes was not uniformly dismal. Up to 20% had reasonable survival after chemoradiation and surgical resection. Stage IV disease should be revised to segregate those with nodal and systemic metastases. © 2008 The Society for Surgery of the Alimentary Tract.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLCen_HK
dc.relation.ispartofJournal of Gastrointestinal Surgeryen_HK
dc.subjectCervical lymph node metastasesen_HK
dc.subjectChemotherapyen_HK
dc.subjectEsophageal carcinomaen_HK
dc.subjectRadiotherapyen_HK
dc.subjectSurgeryen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshAntineoplastic Agentsen_HK
dc.subject.meshCarcinoma, Squamous Cell - pathology - therapyen_HK
dc.subject.meshChemotherapy, Adjuvanten_HK
dc.subject.meshCombined Modality Therapyen_HK
dc.subject.meshEsophageal Neoplasms - pathology - therapyen_HK
dc.subject.meshEsophagectomyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLymph Node Excisionen_HK
dc.subject.meshLymph Nodes - pathologyen_HK
dc.subject.meshLymphatic Metastasisen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshNecken_HK
dc.subject.meshNeoadjuvant Therapyen_HK
dc.subject.meshPrognosisen_HK
dc.subject.meshRadiotherapy, Adjuvanten_HK
dc.subject.meshThoracic Neoplasms - pathology - therapyen_HK
dc.titleCervical nodal metastasis from intrathoracic esophageal squamous cell carcinoma is not necessarily an incurable diseaseen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1091-255X&volume=12&issue=10&spage=1638&epage=1645&date=2008&atitle=Cervical+nodal+metastasis+from+intrathoracic+esophageal+squamous+cell+carcinoma+is+not+necessarily+an+incurable+diseaseen_HK
dc.identifier.emailKwong, DLW: dlwkwong@hku.hken_HK
dc.identifier.emailLaw, S: slaw@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityKwong, DLW=rp00414en_HK
dc.identifier.authorityLaw, S=rp00437en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s11605-008-0654-0en_HK
dc.identifier.pmid18704592-
dc.identifier.scopuseid_2-s2.0-52549128011en_HK
dc.identifier.hkuros152314en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-52549128011&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume12en_HK
dc.identifier.issue10en_HK
dc.identifier.spage1638en_HK
dc.identifier.epage1645en_HK
dc.identifier.isiWOS:000259371500004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTong, DKH=8670837000en_HK
dc.identifier.scopusauthoridKwong, DLW=15744231600en_HK
dc.identifier.scopusauthoridLaw, S=7202241293en_HK
dc.identifier.scopusauthoridWong, KH=36485841700en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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