Lymph node enlargement after definitive chemoradiotherapy for clinical stage I esophageal squamous cell carcinoma

Yoshito Hayashi, Tsutomu Nishida, Masahiko Tsujii, Shusaku Tsutsui, Katsumi Yamamoto, Fumiaki Isohashi, Makoto Yamasaki, Hiroshi Miyata, Motohiko Kato, Takuya Yamada, Shinichiro Shinzaki, Hideki Iijima, Kazuhiko Ogawa, Yuichiro Doki, Tetsuo Takehara

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Chemoradiotherapy (CRT) is an effective modality for stage I esophageal squamous cell carcinoma (ESCC). However, salvage treatments are often required even if complete response (CR) has been achieved. To this end, it is important to accurately diagnose lymph node or other organ metastatic recurrences. Note that lymph node enlargements (except metastatic recurrence) are often detected during the follow-up period after CRT. The purpose of this study was to elucidate the clinical characteristics of lymph node enlargement after CRT.Methods: In this retrospective cohort study, patients diagnosed with stage I (T1 [submucosal invasion] N0M0) ESCC were treated with cisplatin and 5-fluorouracil concurrently with radiotherapy. A total of 55 patients were enrolled in the study from February 2006 to August 2011.Results: The median follow-up period was 46 months. The 3-year overall and progression-free survival rates were 90.7% and 71.2%, respectively, and the CR rate was 87.2% (48/55). Nine of the 48 CR patients were finally diagnosed with recurrences, including 7 lymph node metastases and 2 local recurrences. Lymph node enlargement was initially identified in 20 of the total 55 patients during the follow-up; 9 patients were finally diagnosed with lymph node recurrence, whereas 11 patients had benign reactive lymph node enlargement.Conclusion: The present study demonstrated the high incidence of enlarged lymph nodes after CRT for stage I ESCC. It is important to accurately distinguish between benign lymph node enlargement and recurrent lymph nodes to avoid unnecessary salvage treatments.

Original languageEnglish
Article number706
JournalBMC Cancer
Volume14
Issue number1
DOIs
Publication statusPublished - 2014 Sep 24
Externally publishedYes

Fingerprint

Chemoradiotherapy
Lymph Nodes
Recurrence
Salvage Therapy
Esophageal Squamous Cell Carcinoma
Fluorouracil
Cisplatin
Disease-Free Survival
Cohort Studies
Radiotherapy
Survival Rate
Retrospective Studies
Neoplasm Metastasis
Incidence

Keywords

  • Chemoradiotherapy
  • Esophageal carcinoma
  • Lymph node enlargement

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Genetics
  • Medicine(all)

Cite this

Hayashi, Y., Nishida, T., Tsujii, M., Tsutsui, S., Yamamoto, K., Isohashi, F., ... Takehara, T. (2014). Lymph node enlargement after definitive chemoradiotherapy for clinical stage I esophageal squamous cell carcinoma. BMC Cancer, 14(1), [706]. https://doi.org/10.1186/1471-2407-14-706

Lymph node enlargement after definitive chemoradiotherapy for clinical stage I esophageal squamous cell carcinoma. / Hayashi, Yoshito; Nishida, Tsutomu; Tsujii, Masahiko; Tsutsui, Shusaku; Yamamoto, Katsumi; Isohashi, Fumiaki; Yamasaki, Makoto; Miyata, Hiroshi; Kato, Motohiko; Yamada, Takuya; Shinzaki, Shinichiro; Iijima, Hideki; Ogawa, Kazuhiko; Doki, Yuichiro; Takehara, Tetsuo.

In: BMC Cancer, Vol. 14, No. 1, 706, 24.09.2014.

Research output: Contribution to journalArticle

Hayashi, Y, Nishida, T, Tsujii, M, Tsutsui, S, Yamamoto, K, Isohashi, F, Yamasaki, M, Miyata, H, Kato, M, Yamada, T, Shinzaki, S, Iijima, H, Ogawa, K, Doki, Y & Takehara, T 2014, 'Lymph node enlargement after definitive chemoradiotherapy for clinical stage I esophageal squamous cell carcinoma', BMC Cancer, vol. 14, no. 1, 706. https://doi.org/10.1186/1471-2407-14-706
Hayashi, Yoshito ; Nishida, Tsutomu ; Tsujii, Masahiko ; Tsutsui, Shusaku ; Yamamoto, Katsumi ; Isohashi, Fumiaki ; Yamasaki, Makoto ; Miyata, Hiroshi ; Kato, Motohiko ; Yamada, Takuya ; Shinzaki, Shinichiro ; Iijima, Hideki ; Ogawa, Kazuhiko ; Doki, Yuichiro ; Takehara, Tetsuo. / Lymph node enlargement after definitive chemoradiotherapy for clinical stage I esophageal squamous cell carcinoma. In: BMC Cancer. 2014 ; Vol. 14, No. 1.
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abstract = "Background: Chemoradiotherapy (CRT) is an effective modality for stage I esophageal squamous cell carcinoma (ESCC). However, salvage treatments are often required even if complete response (CR) has been achieved. To this end, it is important to accurately diagnose lymph node or other organ metastatic recurrences. Note that lymph node enlargements (except metastatic recurrence) are often detected during the follow-up period after CRT. The purpose of this study was to elucidate the clinical characteristics of lymph node enlargement after CRT.Methods: In this retrospective cohort study, patients diagnosed with stage I (T1 [submucosal invasion] N0M0) ESCC were treated with cisplatin and 5-fluorouracil concurrently with radiotherapy. A total of 55 patients were enrolled in the study from February 2006 to August 2011.Results: The median follow-up period was 46 months. The 3-year overall and progression-free survival rates were 90.7{\%} and 71.2{\%}, respectively, and the CR rate was 87.2{\%} (48/55). Nine of the 48 CR patients were finally diagnosed with recurrences, including 7 lymph node metastases and 2 local recurrences. Lymph node enlargement was initially identified in 20 of the total 55 patients during the follow-up; 9 patients were finally diagnosed with lymph node recurrence, whereas 11 patients had benign reactive lymph node enlargement.Conclusion: The present study demonstrated the high incidence of enlarged lymph nodes after CRT for stage I ESCC. It is important to accurately distinguish between benign lymph node enlargement and recurrent lymph nodes to avoid unnecessary salvage treatments.",
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AU - Hayashi, Yoshito

AU - Nishida, Tsutomu

AU - Tsujii, Masahiko

AU - Tsutsui, Shusaku

AU - Yamamoto, Katsumi

AU - Isohashi, Fumiaki

AU - Yamasaki, Makoto

AU - Miyata, Hiroshi

AU - Kato, Motohiko

AU - Yamada, Takuya

AU - Shinzaki, Shinichiro

AU - Iijima, Hideki

AU - Ogawa, Kazuhiko

AU - Doki, Yuichiro

AU - Takehara, Tetsuo

PY - 2014/9/24

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N2 - Background: Chemoradiotherapy (CRT) is an effective modality for stage I esophageal squamous cell carcinoma (ESCC). However, salvage treatments are often required even if complete response (CR) has been achieved. To this end, it is important to accurately diagnose lymph node or other organ metastatic recurrences. Note that lymph node enlargements (except metastatic recurrence) are often detected during the follow-up period after CRT. The purpose of this study was to elucidate the clinical characteristics of lymph node enlargement after CRT.Methods: In this retrospective cohort study, patients diagnosed with stage I (T1 [submucosal invasion] N0M0) ESCC were treated with cisplatin and 5-fluorouracil concurrently with radiotherapy. A total of 55 patients were enrolled in the study from February 2006 to August 2011.Results: The median follow-up period was 46 months. The 3-year overall and progression-free survival rates were 90.7% and 71.2%, respectively, and the CR rate was 87.2% (48/55). Nine of the 48 CR patients were finally diagnosed with recurrences, including 7 lymph node metastases and 2 local recurrences. Lymph node enlargement was initially identified in 20 of the total 55 patients during the follow-up; 9 patients were finally diagnosed with lymph node recurrence, whereas 11 patients had benign reactive lymph node enlargement.Conclusion: The present study demonstrated the high incidence of enlarged lymph nodes after CRT for stage I ESCC. It is important to accurately distinguish between benign lymph node enlargement and recurrent lymph nodes to avoid unnecessary salvage treatments.

AB - Background: Chemoradiotherapy (CRT) is an effective modality for stage I esophageal squamous cell carcinoma (ESCC). However, salvage treatments are often required even if complete response (CR) has been achieved. To this end, it is important to accurately diagnose lymph node or other organ metastatic recurrences. Note that lymph node enlargements (except metastatic recurrence) are often detected during the follow-up period after CRT. The purpose of this study was to elucidate the clinical characteristics of lymph node enlargement after CRT.Methods: In this retrospective cohort study, patients diagnosed with stage I (T1 [submucosal invasion] N0M0) ESCC were treated with cisplatin and 5-fluorouracil concurrently with radiotherapy. A total of 55 patients were enrolled in the study from February 2006 to August 2011.Results: The median follow-up period was 46 months. The 3-year overall and progression-free survival rates were 90.7% and 71.2%, respectively, and the CR rate was 87.2% (48/55). Nine of the 48 CR patients were finally diagnosed with recurrences, including 7 lymph node metastases and 2 local recurrences. Lymph node enlargement was initially identified in 20 of the total 55 patients during the follow-up; 9 patients were finally diagnosed with lymph node recurrence, whereas 11 patients had benign reactive lymph node enlargement.Conclusion: The present study demonstrated the high incidence of enlarged lymph nodes after CRT for stage I ESCC. It is important to accurately distinguish between benign lymph node enlargement and recurrent lymph nodes to avoid unnecessary salvage treatments.

KW - Chemoradiotherapy

KW - Esophageal carcinoma

KW - Lymph node enlargement

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