Universität zu Köln

Prenzel, Klaus L., Bollschweiler, Elfriede, Schroeder, Wolfgang, Moenig, Stefan P., Drebber, Uta, Vallboehmer, Daniel and Hoelscher, Arnulf H. (2010). Prognostic Relevance of Skip Metastases in Esophageal Cancer. Ann. Thorac. Surg., 90 (5). S. 1662 - 1670. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1552-6259

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Abstract

Background. Presence of nodal skip metastasis is an established prognostic factor for patients with non-small cell lung cancer. Little is known about this form of lymphatic spread in esophageal cancer. The aim of this study was to assess nodal skip metastasis and its clinical importance for patients with cancer of the esophagus. Methods. Resected lymph nodes of 128 patients with esophageal cancer and pN1 status (adenocarcinoma, n = 67; squamous cell cancer, n = 61) were mapped according to the Japanese lymph-node classification for esophageal cancer. Skip metastases were defined as tumor-free N1 lymph nodes, whereas N2 through N4 lymph nodes harbor metastases. Results. Skip metastases were present in 26 of 128 (20%) patients. There was a higher rate of skip metastasis in early tumors (39% versus 23% versus 14% for T1, T2, and T3 tumors; p = 0.032) and tumors in the middle and upper third of the esophagus (37% versus 15% for upper- and middle-third and lower-third tumors; p = 0.022). Patients with skip metastasis had a significantly better 5-year survival rate than patients with continuous metastasis (53% versus 15%; p < 0.0001). Multivariate analysis revealed skip metastasis as an independent prognostic factor. Conclusions. Skip metastasis is a common form of lymphatic spread in esophageal cancer, which is associated with a favorable prognosis. (Ann Thorac Surg 2010;90:1662-8) (C) 2010 by The Society of Thoracic Surgeons

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Prenzel, Klaus L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bollschweiler, Elfriede UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Moenig, Stefan P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Drebber, Uta UNSPECIFIED UNSPECIFIED UNSPECIFIED Vallboehmer, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf H. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-492906
DOI:	10.1016/j.athoracsur.2010.07.008
Journal or Publication Title:	Ann. Thorac. Surg.
Volume:	90
Number:	5
Page Range:	S. 1662 - 1670
Date:	2010
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1552-6259
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MEDIASTINAL LYMPH-NODES; LUNG-CARCINOMA; TUMOR; LYMPHADENECTOMY; ADENOCARCINOMA; SURVIVAL; JUNCTION; NUMBER; IMPACT; CELLS Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/49290