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Nakajima M, Domeki Y, Satomura H, Takahashi M, Sugawara A, Muroi H, Sasaki K, Yamaguchi S, Miyazaki T, Kuwano H, Kato H. Salvage lymphadenectomy for recurrent esophageal cancer after chemoradiotherapy. Int Surg 2014; 99:452-7. [PMID: 25058783 PMCID: PMC4114379 DOI: 10.9738/intsurg-d-13-00261.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Although salvage esophagectomies are widely performed, reports on salvage lymphadenectomy (SL) are few. We review our SL cases to clarify the indications. Fifty-five patients with esophageal cancer underwent chemoradiotherapy or radiotherapy, including 3 patients with single lymph node (LN) recurrences and one with allochronic double cervical node recurrence. Our department removed 5 recurrent LNs from these 4 patients. In Case 1, right supraclavicular LN was judged to be metastatic and R0 resection was carried out; he is alive without recurrence. In Case 2, we found, allochronically, metastases in his left cervical paraesophageal LN and left supraclavicular LN; residual tumors were R1 in both lesions. He is alive despite esophageal recurrence. In Case 3, a lymphadenectomy was performed on his thoracic para-aortic LN; however, tumor was removed incompletely, and he died 4 months after SL from disease progression. In Case 4, a subcarinal LN was thought to be metastatic, and was removed but no malignant tissues detected. He died 17 months after SL from pneumonia. Our experiences suggest that some patients survive relatively long with SL. Moreover, molecular examination of resected lesions could guide subsequent therapies. SL might be more widely used for these patients if not otherwise contraindicated.
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Affiliation(s)
- Masanobu Nakajima
- Department of Surgery I, Dokkyo Medical University, Mibu, Shimotsuga-gun, Tochigi, Japan
| | - Yasushi Domeki
- Department of Surgery I, Dokkyo Medical University, Mibu, Shimotsuga-gun, Tochigi, Japan
| | - Hitoshi Satomura
- Department of Surgery I, Dokkyo Medical University, Mibu, Shimotsuga-gun, Tochigi, Japan
| | - Masakazu Takahashi
- Department of Surgery I, Dokkyo Medical University, Mibu, Shimotsuga-gun, Tochigi, Japan
| | - Akira Sugawara
- Department of Surgery I, Dokkyo Medical University, Mibu, Shimotsuga-gun, Tochigi, Japan
| | - Hiroto Muroi
- Department of Surgery I, Dokkyo Medical University, Mibu, Shimotsuga-gun, Tochigi, Japan
| | - Kinro Sasaki
- Department of Surgery I, Dokkyo Medical University, Mibu, Shimotsuga-gun, Tochigi, Japan
| | - Satoru Yamaguchi
- Department of Surgery I, Dokkyo Medical University, Mibu, Shimotsuga-gun, Tochigi, Japan
| | - Tatsuya Miyazaki
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Hiroyuki Kuwano
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Hiroyuki Kato
- Department of Surgery I, Dokkyo Medical University, Mibu, Shimotsuga-gun, Tochigi, Japan
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Port JL, Nasar A, Lee PC, Paul S, Stiles BM, Andrews W, Altorki NK. Definitive Therapy for Isolated Esophageal Metastases Prolongs Survival. Ann Thorac Surg 2012; 94:413-9; discussion 419-20. [DOI: 10.1016/j.athoracsur.2012.03.075] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 03/16/2012] [Accepted: 03/21/2012] [Indexed: 11/29/2022]
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