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Postoperative lymphatic recurrence distribution and delineation of the radiation field in lower thoracic squamous cell esophageal carcinomas: a real-world study

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机构: [1]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, People’s Republic of China. [2]Oncology Division I, China Pingmei Shenma Medical Group General Hospital, Kuanggongzhong Rd.1, Xinhua District, Pingdingshan 450052, Henan, People’s Republic of China. [3]Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University and Hebei Cancer Hospital, JianKang Rd.12, Shijiazhuang 050011, Hebei, People’s Republic of China. [4]Department of Radiation Oncology, Shanxi Cancer Hospital, No.3 Workers New Village, Xinghualing District, Taiyuan 030013, Shanxi, People’s Republic of China. [5]Department of Radiation Oncology, Central Theater General Hospital, Wuluo Rd.627, Wuchang District, Wuhan 430061, Hubei, People’s Republic of China.
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关键词: Real-world study Lower thoracic esophageal carcinomas Postoperative lymph node metastasis Clinical target volume delineation

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Background To study lymphatic recurrence distribution after radical surgery in the real world and guide clinical tumor volume delineation for regional lymph nodes during postoperative radiotherapy for lower thoracic squamous cell esophageal carcinomas. Methods We enrolled patients who underwent radical esophagectomy, without radiation before or after surgery, at 3 cancer hospitals. Patients were classified into groups according to tumor locations. We included patients with tumors in the lower thoracic segment and analyzed the postoperative lymph node recurrence mode. A cutoff value of 10% was used to differentiate high-risk lymph node drainage areas from others. Results We enrolled 1905 patients in the whole study series, including 652 thoracic esophageal carcinomas that met our inclusion criteria; there were 241 cases of lower thoracic esophageal carcinomas. 1st, 2nd, 4th, 7th, 8th groups of lymph nodes, according to the 8th edition of the AJCC classification, displayed as high-risk recurrence areas, representing 17.8%, 23.9%, 11.7%, 10.9% and 12.2% of lymph node recurrence. Stage III-IV tumors located in the lower segment of the thoracic esophagus showed a tendency to recur in the left gastric nodes (7.9%) and celiac nodes (10.6%). Conclusions According to our results, we recommended including the 4th, 7th and 8th groups of lymph nodes in the radiation field, and for patients with stage III-IV disease, the 17th and 20th groups of nodes should be irradiated during postoperative treatment. Whether including 1st/2nd groups in preventive irradiation needed more proofs.

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基金编号: BHTPP202026 Y-2019AZMS-0519

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出版当年[2022]版:
大类 | 2 区 医学
小类 | 2 区 核医学 3 区 肿瘤学
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 核医学 3 区 肿瘤学
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出版当年[2022]版:
Q2 ONCOLOGY Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
最新[2023]版:
Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Q2 ONCOLOGY

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第一作者机构: [1]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, People’s Republic of China.
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