Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma
Abstract Background This study evaluated the locations of lymph node recurrence and their association with irradiation fields used for radiotherapy after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma. Methods Medical records of 96 consec...
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doaj-5b9485fbc9ed4c3db6e1410445993a0b2020-11-24T21:49:21ZengWileyCancer Medicine2045-76342019-08-018104547455410.1002/cam4.2365Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinomaToshiki Ikawa0Ryu Ishihara1Koji Konishi2Masahiro Morimoto3Takero Hirata4Naoyuki Kanayama5Sachiko Yamamoto6Noriko Matsuura7Kentaro Wada8Kenji Hayashi9Kazuhiko Ogawa10Teruki Teshima11Department of Radiation Oncology Osaka International Cancer Institute Osaka JapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute Osaka JapanDepartment of Radiation Oncology Osaka International Cancer Institute Osaka JapanDepartment of Radiation Oncology Osaka International Cancer Institute Osaka JapanDepartment of Radiation Oncology Osaka International Cancer Institute Osaka JapanDepartment of Radiation Oncology Osaka International Cancer Institute Osaka JapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute Osaka JapanDepartment of Gastrointestinal Oncology Osaka International Cancer Institute Osaka JapanDepartment of Radiation Oncology Osaka International Cancer Institute Osaka JapanDepartment of Radiation Oncology Osaka International Cancer Institute Osaka JapanDepartment of Radiation Oncology Osaka University Graduate School of Medicine Osaka JapanDepartment of Radiation Oncology Osaka International Cancer Institute Osaka JapanAbstract Background This study evaluated the locations of lymph node recurrence and their association with irradiation fields used for radiotherapy after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma. Methods Medical records of 96 consecutive patients with superficial esophageal squamous cell carcinoma who underwent adjuvant chemoradiotherapy following endoscopic resection were reviewed. Computed tomography was used to identify whether nodal recurrences were within the elective nodal irradiation field. The cumulative incidence of recurrence was calculated, accounting for death as a competing risk. Univariate and multivariate analyses identified factors predicting nodal recurrence. Results The median follow‐up period was 61 months (range: 6‐137 months). Seven patients (7.3%) developed lymph node recurrence only; two patients (2.1%) developed nodal plus local recurrence. Six of the seven cases without local recurrence involved the elective nodal irradiation field, with five cases involving the recurrent nerve lymph nodes. The 5‐year cumulative incidence of lymph node recurrence was higher for T1b tumors with lymphovascular invasion than for T1a tumors with lymphovascular invasion (17.6% vs 6.2%, P = 0.086; HR: 3.74, 95% CI: 0.80‐17.52, P = 0.094) and T1b tumors without lymphovascular invasion (17.6% vs 3.3%, P = 0.031; HR: 6.78, 95% CI: 0.80‐57.63, P = 0.080). Conclusions Lymph node recurrence frequently involved the elective nodal irradiation field, with recurrent nerve lymph nodes being common metastasis sites. The high incidence of nodal recurrence for T1b tumors with lymphovascular invasion highlights a need for new strategies for treating this subset of superficial esophageal squamous cell carcinomas.https://doi.org/10.1002/cam4.2365chemoradiotherapyendoscopic resectionesophageal neoplasmssquamous cell carcinoma |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Toshiki Ikawa Ryu Ishihara Koji Konishi Masahiro Morimoto Takero Hirata Naoyuki Kanayama Sachiko Yamamoto Noriko Matsuura Kentaro Wada Kenji Hayashi Kazuhiko Ogawa Teruki Teshima |
spellingShingle |
Toshiki Ikawa Ryu Ishihara Koji Konishi Masahiro Morimoto Takero Hirata Naoyuki Kanayama Sachiko Yamamoto Noriko Matsuura Kentaro Wada Kenji Hayashi Kazuhiko Ogawa Teruki Teshima Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma Cancer Medicine chemoradiotherapy endoscopic resection esophageal neoplasms squamous cell carcinoma |
author_facet |
Toshiki Ikawa Ryu Ishihara Koji Konishi Masahiro Morimoto Takero Hirata Naoyuki Kanayama Sachiko Yamamoto Noriko Matsuura Kentaro Wada Kenji Hayashi Kazuhiko Ogawa Teruki Teshima |
author_sort |
Toshiki Ikawa |
title |
Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma |
title_short |
Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma |
title_full |
Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma |
title_fullStr |
Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma |
title_full_unstemmed |
Failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma |
title_sort |
failure patterns after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma |
publisher |
Wiley |
series |
Cancer Medicine |
issn |
2045-7634 |
publishDate |
2019-08-01 |
description |
Abstract Background This study evaluated the locations of lymph node recurrence and their association with irradiation fields used for radiotherapy after adjuvant chemoradiotherapy following endoscopic resection for superficial esophageal squamous cell carcinoma. Methods Medical records of 96 consecutive patients with superficial esophageal squamous cell carcinoma who underwent adjuvant chemoradiotherapy following endoscopic resection were reviewed. Computed tomography was used to identify whether nodal recurrences were within the elective nodal irradiation field. The cumulative incidence of recurrence was calculated, accounting for death as a competing risk. Univariate and multivariate analyses identified factors predicting nodal recurrence. Results The median follow‐up period was 61 months (range: 6‐137 months). Seven patients (7.3%) developed lymph node recurrence only; two patients (2.1%) developed nodal plus local recurrence. Six of the seven cases without local recurrence involved the elective nodal irradiation field, with five cases involving the recurrent nerve lymph nodes. The 5‐year cumulative incidence of lymph node recurrence was higher for T1b tumors with lymphovascular invasion than for T1a tumors with lymphovascular invasion (17.6% vs 6.2%, P = 0.086; HR: 3.74, 95% CI: 0.80‐17.52, P = 0.094) and T1b tumors without lymphovascular invasion (17.6% vs 3.3%, P = 0.031; HR: 6.78, 95% CI: 0.80‐57.63, P = 0.080). Conclusions Lymph node recurrence frequently involved the elective nodal irradiation field, with recurrent nerve lymph nodes being common metastasis sites. The high incidence of nodal recurrence for T1b tumors with lymphovascular invasion highlights a need for new strategies for treating this subset of superficial esophageal squamous cell carcinomas. |
topic |
chemoradiotherapy endoscopic resection esophageal neoplasms squamous cell carcinoma |
url |
https://doi.org/10.1002/cam4.2365 |
work_keys_str_mv |
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