International Multicenter Study on the Impact of Extracapsular Lymph Node Involvement in Primary Surgery Adenocarcinoma of the Esophagus on Overall Survival and Staging Systems.

Abstract:

OBJECTIVE:The current pathological lymph node (pN) staging is based on the number of positive lymph nodes but does not take into consideration characteristics of the involved lymph nodes itself. The current study aims to examine the prognostic value of extracapsular lymph node involvement (EC-LNI) and intracapsular lymph node involvement (IC-LNI) for esophageal adenocarcinoma treated by primary surgery. METHODS:From the databases of five European high volume centers, 1639 adenocarcinoma patients with primary R0-resection were withheld after excluding 90-day mortality. Oncologic variables, including number of resected lymph nodes, number of resected positive lymph nodes, and EC-LNI/IC-LNI were examined. The Union Internationale contre le Cancer (UICC) 7th edition prognostic staging was used as baseline staging system. Statistical analysis was performed by Cox proportional hazards modeling and verified using the Random Survival Forest technique. RESULTS:EC-LNI showed significantly worse overall 5-year survival compared with IC-LNI overall (13.4% vs 37.2%, P < 0.0001), including in each pN-category [16.4% vs 45.6% in pN1 (P < 0.0001), 16.1% vs 23.8% (P = 0.047) in pN2 (P = 0.065), and 8.7% vs 26.3% in pN3 categories, respectively]. pN1 IC-LNI patients show a 5-year overall survival comparable (P = 0.92) with stage IIB (ie, pT3N0). Reclassifying the UICC prognostic stages according to these findings into an adapted staging model showed a significant (P < 0.0001) increase in homogeneity, discriminatory ability, and monotonicity compared with the original UICC TNM 7th edition prognostic staging. CONCLUSIONS:These data suggest that lymph node capsular status is an important prognostic factor and should be considered for the future edition of the TNM staging system for esophageal cancer.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Nafteux PR,Lerut AM,Moons J,Hölscher AH,Bollschweiler E,van Berge Henegouwen MI,Lagarde SM,van Lanschot JJ,Messager M,Mariette C,D'Journo XB,Thomas PA,De Leyn PR

doi

10.1097/SLA.0000000000001463

subject

Has Abstract

pub_date

2015-11-01 00:00:00

pages

809-15; discussion 815-6

issue

5

eissn

0003-4932

issn

1528-1140

pii

00000658-201511000-00016

journal_volume

262

pub_type

杂志文章,多中心研究,随机对照试验
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    authors: Easter DW,Cuschieri A

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    authors: Dedy NJ,Fecso AB,Szasz P,Bonrath EM,Grantcharov TP

    更新日期:2016-05-01 00:00:00

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    abstract::After attaching appropriate monitoring devices enabling the measurement of the slope of the left ventricular function curve, left atrial pressure, mean aortic pressure, peak left ventricular pressure, and tension time index, three groups of ten dogs were subjected to varying periods of hemorrhagic shock until a slope ...

    journal_title:Annals of surgery

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    doi:10.1097/00000658-197501000-00025

    authors: Proctor HJ,Hsiao H,Fry J,Ebert C

    更新日期:1975-01-01 00:00:00

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    authors: Romanus ME,Neal JA,Dilley WG,Leight GS,Linehan WM,Santen RJ,Farndon JR,Jones RS,Wells SA Jr

    更新日期:1983-05-01 00:00:00

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    authors: Li AK,Ehrlich HP,Trelstad RL,Koroly MJ,Schattenkerk ME,Malt RA

    更新日期:1980-02-01 00:00:00

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    authors: Gold JS,Are C,Kornprat P,Jarnagin WR,Gönen M,Fong Y,DeMatteo RP,Blumgart LH,D'Angelica M

    更新日期:2008-01-01 00:00:00

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    doi:10.1097/00000658-198306000-00009

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    更新日期:1983-06-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000658-199202000-00009

    authors: Somers RG,Jablon LK,Kaplan MJ,Sandler GL,Rosenblatt NK

    更新日期:1992-02-01 00:00:00

  • Impact of neoadjuvant chemoradiation on lymph node status in esophageal cancer: post hoc analysis of a randomized controlled trial.

    abstract:OBJECTIVE:The study objectives were to analyze the impact of the number of lymph nodes (LNs) reported as resected (NLNr) and the number of LNs invaded (NLNi) on the prognosis of esophageal cancer (EC) after neoadjuvant chemoradiotherapy. BACKGROUND:Pathological LN status is a major disease prognostic factor and marker...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/SLA.0000000000000991

    authors: Robb WB,Dahan L,Mornex F,Maillard E,Thomas PA,Meunier B,Boige V,Pezet D,Le Brun-Ly V,Bosset JF,Mabrut JY,Triboulet JP,Bedenne L,Seitz JF,Mariette C,Fédération Française de Cancérologie Digestive, Société Française de Radiot

    更新日期:2015-05-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1097/00000658-198005000-00008

    authors: Sterchi JM,Myers RT

    更新日期:1980-05-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181b41d53

    authors: Regenbogen SE,Gawande AA,Lipsitz SR,Greenberg CC,Jha AK

    更新日期:2009-09-01 00:00:00

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    doi:10.1097/00000658-199101000-00011

    authors: Hiraide A,Katayama M,Sugimoto H,Yoshioka T,Sugimoto T

    更新日期:1991-01-01 00:00:00

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    authors: Iglehart JD,Miron A,Rimer BK,Winer EP,Berry D,Shildkraut MJ

    更新日期:1998-09-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31827ee6b0

    authors: Rhinehart ZJ,Guyette FX,Sperry JL,Forsythe RM,Murdock A,Alarcon LH,Peitzman AB,Rosengart MR

    更新日期:2013-06-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1097/00000658-197807000-00017

    authors: Bjornson AB,Altemeier WA,Bjornson HS

    更新日期:1978-07-01 00:00:00

  • SM22 a Plasma Biomarker for Human Transmural Intestinal Ischemia.

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    pub_type: 杂志文章

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    authors: Schellekens DHSM,Reisinger KW,Lenaerts K,Hadfoune M,Olde Damink SW,Buurman WA,Dejong CHC,Derikx JPM

    更新日期:2018-07-01 00:00:00

  • Acute hand burns in children: management and long-term outcome based on a 10-year experience with 698 injured hands.

    abstract:OBJECTIVE:To document long-term results associated with an coordinated plan of care for acutely burned hands in children. SUMMARY AND BACKGROUND DATA:Optimal hand function is a crucial component of a high-quality survival after burn injury. This can be achieved only with a coordinated approach to the injuries. Long-te...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199904000-00016

    authors: Sheridan RL,Baryza MJ,Pessina MA,O'Neill KM,Cipullo HM,Donelan MB,Ryan CM,Schulz JT,Schnitzer JJ,Tompkins RG

    更新日期:1999-04-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1097/00000658-199209000-00010

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    更新日期:1992-09-01 00:00:00

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    pub_type: 杂志文章

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    更新日期:1976-01-01 00:00:00

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    abstract:OBJECTIVE:To compare the modified Rossetti fundoplication with the classic Nissen. SUMMARY BACKGROUND DATA:The traditional surgical treatment of gastroesophageal reflux in children has been the classic Nissen fundoplication, defined by liver mobilization, crural repair, takedown of short gastric vessels, and floppy wr...

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    pub_type: 杂志文章

    doi:10.1097/00000658-199906000-00003

    authors: Levy MS,Sorrels CW,Wagner CW,Jackson RJ,Barnes RW,Smith SD

    更新日期:1999-06-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198512000-00004

    authors: Knaus WA,Draper EA,Wagner DP,Zimmerman JE

    更新日期:1985-12-01 00:00:00

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    pub_type: 杂志文章

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    更新日期:2010-04-01 00:00:00

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    pub_type: 杂志文章

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  • Timing But Not Patterns of Recurrence Is Different Between Node-negative and Node-positive Resected Pancreatic Cancer.

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    pub_type: 杂志文章,多中心研究

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    更新日期:1998-05-01 00:00:00

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    doi:10.1097/00000658-198604000-00017

    authors: Walther B,Löwenhielm P,Strand SE,Ståhlberg F,Uvelius B,Oscarson J,Evander A

    更新日期:1986-04-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181e4846e

    authors: Bilimoria KY,Cohen ME,Ingraham AM,Bentrem DJ,Richards K,Hall BL,Ko CY

    更新日期:2010-07-01 00:00:00

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    abstract::Nine patients with arteriographic right colon arteriovenous malformations (AVM's) are reviewed. Even though five of the eight surviving patients had diverticulosis in remaining colon, right colectomy with removal of the AVM effectively controlled bleeding in seven of the eight patients in follow-up intervals of 14-66 ...

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    pub_type: 杂志文章

    doi:10.1097/00000658-197908000-00013

    authors: Talman EA,Dixon DS,Gutierrez FE

    更新日期:1979-08-01 00:00:00