Patterns of Lymph Node Recurrence after Esophagectomy of pT2-3 N0M0 Esophageal Squamous Cell Carcinoma.

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2025-05-15 DOI:10.1007/s12029-025-01242-8

Mei Kang, Yichun Wang, Li Niu

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Abstract

Purpose: This study aims to elucidate the distribution patterns of lymph node recurrence (LNR) in patients with pT2-3N0M0 esophageal squamous cell carcinoma (ESCC) following esophagectomy.

Methods: A comprehensive retrospective analysis was conducted on 96 pT2-3N0M0 ESCC patients who experienced postoperative LNR at our institution between January 2010 and August 2019. LNR sites were systematically categorized into cervical, mediastinal, and abdominal regions. Computed tomography imaging was digitally reconstructed to precisely map recurrence locations, followed by rigorous statistical analysis of distribution patterns.

Results: The final cohort comprised 96 patients with confirmed LNR, with males constituting 79.2% of the sample and a median age of 61 years. Mediastinal LNR was determined to be the most prevalent (69.8%), followed by cervical (43.8%) and abdominal (33.3%) regions. Cervical recurrences were predominantly identified in lymph node station 104R/L (7.8%), while mediastinal recurrences were predominantly localized to station 106recR (14.5%) and station 105 (10.4%), and abdominal recurrences were concentrated in stations 16a2 (3.6%) and 9 (3.6%). Computerized tomography reconstruction demonstrated a distinctive "T"-shaped distribution of LNR in the cervical and upper mediastinal regions in proximity to major vascular structures. The primary tumor location was not found to significantly influence LNR distribution patterns (P > 0.05).

Conclusions: LNR in pT2-3N0M0 ESCC predominantly manifests in cervical and upper mediastinal lymph nodes. Administering targeted adjuvant radiotherapy to high-risk patients may be an effective strategy for enhancing therapeutic outcomes. Prospective multicenter studies are warranted to validate these preliminary findings.

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pT2-3 N0M0食管鳞状细胞癌食管切除术后淋巴结复发的特点。

目的：本研究旨在探讨pT2-3N0M0食管鳞癌（ESCC）术后淋巴结复发（LNR）的分布规律。方法：对我院2010年1月至2019年8月96例pT2-3N0M0 ESCC术后LNR患者进行全面回顾性分析。LNR部位系统地分为颈部、纵隔和腹部。对计算机断层成像进行数字重建以精确地绘制复发位置，然后对分布模式进行严格的统计分析。结果：最终队列包括96例确诊LNR患者，男性占79.2%，中位年龄61岁。纵隔LNR最常见（69.8%），其次是宫颈（43.8%）和腹部（33.3%）。颈部复发主要发生在104R/L淋巴结站（7.8%），纵隔复发主要集中在106recR站（14.5%）和105站（10.4%），腹部复发集中在16a2站（3.6%）和9站（3.6%）。计算机断层重建显示LNR在靠近主要血管结构的颈部和上纵隔区域呈独特的“T”形分布。原发肿瘤位置对LNR分布无显著影响（P < 0.05）。结论：pT2-3N0M0型ESCC中LNR主要表现在颈部和上纵隔淋巴结。对高危患者进行靶向辅助放疗可能是提高治疗效果的有效策略。有必要进行前瞻性多中心研究来验证这些初步发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.