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Article: Predicting systemic disease in patients with esophageal cancer after esophagectomy a multinational study on the significance of the number of involved lymph nodes

TitlePredicting systemic disease in patients with esophageal cancer after esophagectomy a multinational study on the significance of the number of involved lymph nodes
Authors
Issue Date2008
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
Citation
Annals Of Surgery, 2008, v. 248 n. 6, p. 979-984 How to Cite?
AbstractObjective: The aim of this study was to determine whether the risk of systemic disease after esophagectomy can be predicted by the number of involved lymph nodes. Summary Background Data: Primary esophagectomy is curative in some but not all patients with esophageal cancer. Identifcation of patients at high risk for systemic disease would allow selective use of additional systemic therapy. This study is a multinational, retro- spective review of patients treated with resection alone to assess the impact of the number of involved lymph nodes on the probability of systemic disease. Methods: The study population included 1053 patients with esoph- ageal cancer (700 adenocarcinoma, 353 squamous carcinoma) who underwent R0 esophagectomy with ≥15 lymph nodes resected at 9 international centers: Asia (1), Europe (5), and United States (3). To ensure a minimum potential follow-up of 5 years, only patients who had esophagectomy before October 2002 were included. Patients treated with neoadjuvant or adjuvant therapy were excluded. The impact of the number of involved lymph nodes on the risk of systemic disease recurrence was assessed using univariate and multivariate analyses. Results: Systemic disease occurred in 40%. The number of involved lymph nodes ranged from 0 to 26 with 55% of patients having at least 1 involved lymph node. The frequency of systemic disease after esophagectomy was 16% for those without nodal involvement and progressively increased to 93% in patients with 8 or more involved lymph nodes. Conclusions: This study shows that the number of involved lymph nodes can be used to predict the likelihood of systemic disease in patients with esophageal cancer. The probability of systemic disease exceeds 50% when 3 or more nodes are involved and approaches 100% when the number of involved nodes is 8 or more. Additional therapy is warranted in these patients with a high probability of systemic disease. Copyright © 2008 by Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/59974
ISSN
2015 Impact Factor: 8.569
2015 SCImago Journal Rankings: 4.503
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorPeyre, CGen_HK
dc.contributor.authorHagen, JAen_HK
dc.contributor.authorDeMeester, SRen_HK
dc.contributor.authorVan Lanschot, JJBen_HK
dc.contributor.authorHölscher, Aen_HK
dc.contributor.authorLaw, Sen_HK
dc.contributor.authorRuol, Aen_HK
dc.contributor.authorAncona, Een_HK
dc.contributor.authorGriffin, SMen_HK
dc.contributor.authorAltorki, NKen_HK
dc.contributor.authorRice, TWen_HK
dc.contributor.authorWong, Jen_HK
dc.contributor.authorLerut, Ten_HK
dc.contributor.authorDeMeester, TRen_HK
dc.date.accessioned2010-05-31T04:01:12Z-
dc.date.available2010-05-31T04:01:12Z-
dc.date.issued2008en_HK
dc.identifier.citationAnnals Of Surgery, 2008, v. 248 n. 6, p. 979-984en_HK
dc.identifier.issn0003-4932en_HK
dc.identifier.urihttp://hdl.handle.net/10722/59974-
dc.description.abstractObjective: The aim of this study was to determine whether the risk of systemic disease after esophagectomy can be predicted by the number of involved lymph nodes. Summary Background Data: Primary esophagectomy is curative in some but not all patients with esophageal cancer. Identifcation of patients at high risk for systemic disease would allow selective use of additional systemic therapy. This study is a multinational, retro- spective review of patients treated with resection alone to assess the impact of the number of involved lymph nodes on the probability of systemic disease. Methods: The study population included 1053 patients with esoph- ageal cancer (700 adenocarcinoma, 353 squamous carcinoma) who underwent R0 esophagectomy with ≥15 lymph nodes resected at 9 international centers: Asia (1), Europe (5), and United States (3). To ensure a minimum potential follow-up of 5 years, only patients who had esophagectomy before October 2002 were included. Patients treated with neoadjuvant or adjuvant therapy were excluded. The impact of the number of involved lymph nodes on the risk of systemic disease recurrence was assessed using univariate and multivariate analyses. Results: Systemic disease occurred in 40%. The number of involved lymph nodes ranged from 0 to 26 with 55% of patients having at least 1 involved lymph node. The frequency of systemic disease after esophagectomy was 16% for those without nodal involvement and progressively increased to 93% in patients with 8 or more involved lymph nodes. Conclusions: This study shows that the number of involved lymph nodes can be used to predict the likelihood of systemic disease in patients with esophageal cancer. The probability of systemic disease exceeds 50% when 3 or more nodes are involved and approaches 100% when the number of involved nodes is 8 or more. Additional therapy is warranted in these patients with a high probability of systemic disease. Copyright © 2008 by Lippincott Williams & Wilkins.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.comen_HK
dc.relation.ispartofAnnals of Surgeryen_HK
dc.rightsAnnals of Surgery. Copyright © Lippincott Williams & Wilkins.en_HK
dc.titlePredicting systemic disease in patients with esophageal cancer after esophagectomy a multinational study on the significance of the number of involved lymph nodesen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0003-4932&volume=248&issue=6&spage=979&epage=985&date=2008&atitle=Predicting+systemic+disease+in+patients+with+esophageal+cancer+after+esophagectomy:+a+multinational+study+on+the+significance+of+the+number+of+involved+lymph+nodesen_HK
dc.identifier.emailLaw, S: slaw@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLaw, S=rp00437en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/SLA.0b013e3181904f3cen_HK
dc.identifier.scopuseid_2-s2.0-58149399165en_HK
dc.identifier.hkuros154268en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-58149399165&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume248en_HK
dc.identifier.issue6en_HK
dc.identifier.spage979en_HK
dc.identifier.epage984en_HK
dc.identifier.isiWOS:000262025600010-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridPeyre, CG=6602729845en_HK
dc.identifier.scopusauthoridHagen, JA=7102359968en_HK
dc.identifier.scopusauthoridDeMeester, SR=7006890432en_HK
dc.identifier.scopusauthoridVan Lanschot, JJB=35394270900en_HK
dc.identifier.scopusauthoridHölscher, A=7102202249en_HK
dc.identifier.scopusauthoridLaw, S=7202241293en_HK
dc.identifier.scopusauthoridRuol, A=7005033564en_HK
dc.identifier.scopusauthoridAncona, E=7006773077en_HK
dc.identifier.scopusauthoridGriffin, SM=7201880907en_HK
dc.identifier.scopusauthoridAltorki, NK=7006645610en_HK
dc.identifier.scopusauthoridRice, TW=7201893679en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK
dc.identifier.scopusauthoridLerut, T=20834801600en_HK
dc.identifier.scopusauthoridDeMeester, TR=35421636200en_HK

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