Improved Tissue Processing in Esophageal Adenocarcinoma After Ivor Lewis Esophagectomy Allows Histological Analysis of All Surgically Removed Lymph Nodes with Significant Effects on Nodal UICC Stages

Quaas, A., Schloesser, H., Fuchs, H., Zander, T., Arolt, C., Scheel, A. H., Rueschoff, J., Bruns, C., Buettner, R. and Schroeder, W. . Improved Tissue Processing in Esophageal Adenocarcinoma After Ivor Lewis Esophagectomy Allows Histological Analysis of All Surgically Removed Lymph Nodes with Significant Effects on Nodal UICC Stages. Ann. Surg. Oncol.. NEW YORK: SPRINGER. ISSN 1534-4681

Full text not available from this repository.

DOI:10.1245/s10434-020-09450-1

Abstract

Background In esophageal carcinoma, the numbers of metastatic and total removed lymph nodes (LN) are well-established variables of long-term prognosis. The overall rate of retrieved LN depends on neoadjuvant treatment, the extent of surgical lymphadenectomy, and the modality of the pathological workup. The question in this study is whether technically extended histopathological preparation can increase the number of detected (metastatic) LN with an impact on nodal UICC staging. Patients and Methods A cohort of 77 patients with esophageal adenocarcinoma was treated with Ivor Lewis esophagectomy including standardized two-field lymphadenectomy. The specimens were grossed, and all manually detectable LN were retrieved. The remaining tissue was completely embedded by the advanced acetone compression retrieval technique. The primary outcome parameter was the total number of detected lymph nodes before and after acetone workup. Results A mean number of 23,1 LN was diagnosed after standard manual LN preparation. With complete embedding of the fatty tissue using acetone compression, the number increased to 40.5 lymph nodes (p < 0.0001). The mean number of metastatic LN increased from 3.2 to 4.2 nodal metastases following acetone compression (p < 0.0001). Additional LN metastases which caused a change in the primary (y)pN stage were found in ten patients (13.0%). Conclusions Advanced lymph node retrieval by acetone compression allows a reliable statement on the real number of removed LN. Results demonstrate an impact on the nodal UICC stage. A future multicenter study will examine the prognostic impact of improved lymph node retrieval on long-term oncologic outcome.

Item Type:

Journal Article

Creators:

Creators	Email	ORCID	ORCID Put Code
Quaas, A.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Schloesser, H.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Fuchs, H.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Zander, T.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Arolt, C.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Scheel, A. H.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Rueschoff, J.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Bruns, C.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Buettner, R.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Schroeder, W.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED