Lymphatic spread and microinvolvement in adenocarcinoma of the esophago-gastric junction.
Standard
Lymphatic spread and microinvolvement in adenocarcinoma of the esophago-gastric junction. / Schurr, Paulus; Yekebas, Emre F; Kaifi, Jussuf; Lasch, Steffi; Strate, Tim; Kutup, Asad; Cataldegirmen, Guel; Bubenheim, Michael; Pantel, Klaus; Izbicki, Jakob R.
in: J SURG ONCOL, Jahrgang 94, Nr. 4, 4, 2006, S. 307-315.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Lymphatic spread and microinvolvement in adenocarcinoma of the esophago-gastric junction.
AU - Schurr, Paulus
AU - Yekebas, Emre F
AU - Kaifi, Jussuf
AU - Lasch, Steffi
AU - Strate, Tim
AU - Kutup, Asad
AU - Cataldegirmen, Guel
AU - Bubenheim, Michael
AU - Pantel, Klaus
AU - Izbicki, Jakob R
PY - 2006
Y1 - 2006
N2 - BACKGROUND: Adenocarcinoma of the esophago-gastric junction (EGJ) potentially spreads to abdominal and mediastinal lymph nodes. METHODS: Eighty-five patients with type I and II EGJ cancer underwent curative esophagectomy or esophago-gastrectomy and radical abdominal and mediastinal lymphadenectomy. Microinvolvement was detected with the mAb Ber-Ep4 in all histopathologically free lymph nodes. RESULTS: In type I tumors (n = 40), lower mediastinal lymph nodes were positive in 24% and among type II tumors (n = 45) in 10% of patients. Ber-Ep4+ cells in apparently free lymph nodes were found in 49% of patients. On inclusion of Ber-Ep4+ nodes, positive mediastinal lymph node staging was rising to 40 and 33% in type I and II patients, respectively. After a median observation time of 27.1 months, 37 of 85 patients (43.5%) had died of tumor disease. Kaplan-Meier analysis revealed a significant impact of nodal microinvolvement on disease-specific survival for type I and type II tumors (P = 0.016 and P <0.001, respectively). Cox regression analysis revealed a 2.77 higher independent risk (P = 0.002) for nodal microinvolvement. CONCLUSIONS: Lymphatic microinvolvement shows a high incidence in curatively resected EGJ cancer. Spread to mediastinal lymph nodes seems to necessitate lymphadenectomy of the thoracic cavity in either type.
AB - BACKGROUND: Adenocarcinoma of the esophago-gastric junction (EGJ) potentially spreads to abdominal and mediastinal lymph nodes. METHODS: Eighty-five patients with type I and II EGJ cancer underwent curative esophagectomy or esophago-gastrectomy and radical abdominal and mediastinal lymphadenectomy. Microinvolvement was detected with the mAb Ber-Ep4 in all histopathologically free lymph nodes. RESULTS: In type I tumors (n = 40), lower mediastinal lymph nodes were positive in 24% and among type II tumors (n = 45) in 10% of patients. Ber-Ep4+ cells in apparently free lymph nodes were found in 49% of patients. On inclusion of Ber-Ep4+ nodes, positive mediastinal lymph node staging was rising to 40 and 33% in type I and II patients, respectively. After a median observation time of 27.1 months, 37 of 85 patients (43.5%) had died of tumor disease. Kaplan-Meier analysis revealed a significant impact of nodal microinvolvement on disease-specific survival for type I and type II tumors (P = 0.016 and P <0.001, respectively). Cox regression analysis revealed a 2.77 higher independent risk (P = 0.002) for nodal microinvolvement. CONCLUSIONS: Lymphatic microinvolvement shows a high incidence in curatively resected EGJ cancer. Spread to mediastinal lymph nodes seems to necessitate lymphadenectomy of the thoracic cavity in either type.
M3 - SCORING: Zeitschriftenaufsatz
VL - 94
SP - 307
EP - 315
JO - J SURG ONCOL
JF - J SURG ONCOL
SN - 0022-4790
IS - 4
M1 - 4
ER -
