BACKGROUND/AIM: Malignant nodes in patients with localized esophageal adenocarcinoma (L-EAC) portend a poor prognosis. We assessed the correlation of the distribution of nodes with the outcome of patients undergoing chemoradiation/surgery (trimodality therapy). METHODS: We studied 209 L-EAC patients who had confirmed or suspicious nodes at baseline staging. All patients received trimodality therapy and were grouped according to the nodal geography: above the diaphragm (AD), below the diaphragm (BD), or above and below the diaphragm (ABD). Survival estimates were calculated using the Kaplan-Meier method, and the outcomes of the groups were assessed by the log-rank test. RESULTS: Patients were primarily Caucasian (91%) and male (93%), with a baseline stage III L-EAC (89%). The median follow-up was 2.8 years (range, 0.4-11.7). Of the 209 patients, 35% (n = 73) had AD nodes, 20% (n = 41) had BD nodes, and 45% (n = 95) had ABD nodes. ABD patients had a 5-year overall survival rate of 33%, whereas this rate was 55% in AD patients and 60% in BD patients (p = 0.02). Patients with a higher histology grade were also at a higher risk of relapse and had a poor survival (p < 0.01 for both). CONCLUSIONS: L-EAC patients in the ABD group had the worst outcome after trimodality treatment compared to those in the AD or BD group. Novel strategies are needed for ABD patients.
BACKGROUND/AIM: Malignant nodes in patients with localized esophageal adenocarcinoma (L-EAC) portend a poor prognosis. We assessed the correlation of the distribution of nodes with the outcome of patients undergoing chemoradiation/surgery (trimodality therapy). METHODS: We studied 209 L-EACpatients who had confirmed or suspicious nodes at baseline staging. All patients received trimodality therapy and were grouped according to the nodal geography: above the diaphragm (AD), below the diaphragm (BD), or above and below the diaphragm (ABD). Survival estimates were calculated using the Kaplan-Meier method, and the outcomes of the groups were assessed by the log-rank test. RESULTS:Patients were primarily Caucasian (91%) and male (93%), with a baseline stage III L-EAC (89%). The median follow-up was 2.8 years (range, 0.4-11.7). Of the 209 patients, 35% (n = 73) had AD nodes, 20% (n = 41) had BD nodes, and 45% (n = 95) had ABD nodes. ABD patients had a 5-year overall survival rate of 33%, whereas this rate was 55% in ADpatients and 60% in BD patients (p = 0.02). Patients with a higher histology grade were also at a higher risk of relapse and had a poor survival (p < 0.01 for both). CONCLUSIONS:L-EACpatients in the ABD group had the worst outcome after trimodality treatment compared to those in the AD or BD group. Novel strategies are needed for ABD patients.
Authors: Jaime Chen; Ronghui Xu; Gordon C Hunt; Mary Lee Krinsky; Thomas J Savides Journal: Clin Gastroenterol Hepatol Date: 2006-05 Impact factor: 11.382
Authors: Takashi Taketa; Kazuki Sudo; Arlene M Correa; Roopma Wadhwa; Hironori Shiozaki; Elena Elimova; Maria-Claudia Campagna; Mariela A Blum; Heath D Skinner; Ritsuko U Komaki; Jeffrey H Lee; Manoop S Bhutani; Brian R Weston; David C Rice; Stephen G Swisher; Dipen M Maru; Wayne L Hofstetter; Jaffer A Ajani Journal: J Natl Compr Canc Netw Date: 2014-08 Impact factor: 11.908
Authors: Brechtje A Grotenhuis; Bas P L Wijnhoven; Jan Werner Poley; John J Hermans; Katharina Biermann; Manon C W Spaander; Marco J Bruno; Hugo W Tilanus; J Jan B van Lanschot Journal: World J Surg Date: 2013-01 Impact factor: 3.352
Authors: Kazuki Sudo; Takashi Taketa; Arlene M Correa; Maria-Claudia Campagna; Roopma Wadhwa; Mariela A Blum; Ritsuko Komaki; Jeffrey H Lee; Manoop S Bhutani; Brian Weston; Heath D Skinner; Dipen M Maru; David C Rice; Stephen G Swisher; Wayne L Hofstetter; Jaffer A Ajani Journal: J Clin Oncol Date: 2013-10-21 Impact factor: 44.544