Metastatic incidence of (PET)CT positive lung hilar and retroperitoneal lymph nodes in esophageal cancer patients |
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| Institution: | 1. Department of Thoracic Surgery, The Second People’s Hospital of Nantong, Nantong, Jiangsu, China;2. Department of Radiation Oncology, Nantong Tumor Hospital, Nantong, Jiangsu, China;1. Department of Oncology, the First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, 150001 Harbin, Heilongjiang, PR China;2. Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, PR China;1. Department ofPathology, The First Hospital Affiliated with Shandong First Medical University, Jinan, China;2. Department of Pathology, LiaoCheng People’s Hospital, LiaoCheng, China;3. Department of General Surgery, Qilu Hospital of Shandong University, China;4. Shandong University Medical School, Jinan, Shandong, China;1. Women''s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran;2. Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran;3. Breast Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran;4. Department of Physiology, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran;5. Department of Medical Genetics, School of Medicine, Babol University of Medical Sciences, Babol, Iran;6. Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran;7. Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran |
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| Abstract: | BackgroundExtra-regional lymph node metastases strongly determine treatment options in patients with esophageal cancer. Staging modalities such as (FDG-PET) CT scanning frequently show activity in retroperitoneal and lung hilar lymph nodes. This study evaluated the incidence of histologically confirmed metastases, treatment approach and recurrence patterns in patients with (FDG-PET) CT positivity in these regions.MethodsAll patients with (FDG-PET-) CT positive hilar and/or retroperitoneal lymph nodes at primary staging or restaging discussed at a multidisciplinary tumor board meeting for staging of esophageal cancer between January 2012–December 2017 were included. Biopsies and follow-up were evaluated to determine the presence of metastases and progression rates.ResultsFrom 2012 to 2017, 65 of 857 patients (7.6%) were selected with positive retroperitoneal and/or hilar lymph nodes. A total of 47/65 (72.3%) patients had positive retroperitoneal lymph nodes, which contained metastases in 19 (29.2%). When no biopsy was performed and curative treatment was given (n = 14), 9 patients had progression or locoregional and distant recurrence. Positive hilar lymph nodes were identified in 21 (32.3%) patients; 4 were biopsied and none contained metastases. In these patients no recurrence of disease was seen during follow-up.ConclusionsThe majority of biopsied (PET)CT-positive retroperitoneal lymph nodes at staging contained metastases, while biopsied (PET)CT-positive hilar nodes did not. Histological evaluation of (PET)CT -positive retroperitoneal lymph nodes at staging imaging is recommended, while based on this small series, (PET)CT-positive hilar lymph nodes most likely represent reactive lymphadenopathy. |
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| Keywords: | Lymph nodes Metastases Staging Esophageal cancer |
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