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Correlation between histological effects on the main tumors and nodal status after chemoradiotherapy for squamous cell carcinoma of the esophagus
Author(s) -
Yano Masahiko,
Yasuda Takushi,
Miyata Hiroshi,
Fujiwara Yoshiyuki,
Takiguchi Shuji,
Monden Morito
Publication year - 2005
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20209
Subject(s) - medicine , chemoradiotherapy , pathological , esophagus , esophageal cancer , lymph node , cancer , esophagectomy , biopsy , carcinoma , pathological staging , oncology , radiology , gastroenterology , pathology
Background and Objectives Although the histological effectiveness of preoperative chemoradiotherapy against the main tumor is reported to be the strongest prognostic factor for patients with esophageal cancer, it remains unknown whether such chemoradiotherapy is equally effective against metastatic lymph nodes. Methods We studied 103 consecutive patients with esophageal cancer, who were given preoperative chemoradiotherapy followed by surgery. The histological effectiveness against the main tumor of the chemoradiotherapy was correlated with lymph mode metastasis and other clinico‐pathological factors. Results The histological effectiveness against the main tumor was grade 3 in 26 patients, grade 2 in 49 and grade 1 in 28. The number of pathological node‐negative patients was 21 (80.8%), 19 (38.8%), and 7 (25.0%) in those having grade 3, 2, and 1 responses of their main tumors, respectively. The average number of pathological metastatic lymph nodes was 0.19, 1.4, and 4.4 in patients with grade 3, 2, and 1 responses, respectively. Endoscopic biopsy after the chemoradiotherapy could not accurately diagnose the pathological complete response (CR) of the main tumors, with a high false negative rate (60.9%). Conclusions The effects of chemoradiotherapy against main tumors significantly correlated with nodal status. Most patients with main tumors of pathological CR are node‐negative. Patients with a grade 2 response have at most a few positive nodes. Surgery would be most beneficial for such patients. J. Surg. Oncol. 2005;89:244–250. © 2005 Wiley‐Liss, Inc.