The Journal of Thoracic and Cardiovascular Surgery
Volume 139, Issue 2 , Pages 387-394 , February 2010

Predictors of survival in patients with persistent nodal metastases after preoperative chemotherapy for esophageal cancer

Read at the Eighty-ninth Annual Meeting of The American Association for Thoracic Surgery, Boston, Massachusetts, May 9–13, 2009.

  • Brendon M. Stiles, MD

      Affiliations

    • Division of Thoracic Surgery, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY
  • ,
  • Paul Christos, PhD

      Affiliations

    • Department of Biostatistics and Epidemiology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY
  • ,
  • Jeffrey L. Port, MD

      Affiliations

    • Division of Thoracic Surgery, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY
  • ,
  • Paul C. Lee, MD

      Affiliations

    • Division of Thoracic Surgery, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY
  • ,
  • Subroto Paul, MD

      Affiliations

    • Division of Thoracic Surgery, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY
  • ,
  • James Saunders, BS

      Affiliations

    • Division of Thoracic Surgery, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY
  • ,
  • Nasser K. Altorki, MD

      Affiliations

    • Division of Thoracic Surgery, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY
    • Corresponding Author InformationAddress for reprints: Nasser K. Altorki, MD, Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Suite M404, New York Presbyterian–Weill Cornell Medical Center, 525 East 68th St, New York, NY10021.

Received 18 May 2009 ,Revised 3 September 2009 ,Accepted 1 October 2009.

References 

  1. Gebski V, Burmeister B, Smithers BM, Foo K, Zalcberg J, Simes J. Australasian Gastro-Intestinal Trials Group. Survival benefits from neoadjuvant chemoradiotherapy or chemotherapy in oesophageal carcinoma: a meta-analysis. Lancet Oncol. 2007;8:226–234
  2. Bates BA, Detterbeck F, Bernard SA, Qaqish BF, Tepper JE. Concurrent radiation therapy and chemotherapy followed by esophagectomy for localized esophageal carcinoma. J Clin Oncol. 1996;14:156–163
  3. Stahl M, Wilke H, Fink U, Stuschke M, Walz MK, Siewert JR, et al. Combined preoperative chemotherapy and radiotherapy in patients with locally advanced esophageal cancer. Interim analysis of a phase II trial. J Clin Oncol. 1996;14:829–837
  4. Urba SG, Orringer M, Turrisi A, Iannettoni M, Forastiere A, Strawderman M. Randomized trial of preoperative chemoradiation versus surgery alone in patients with locoregional esophageal carcinoma. J Clin Oncol. 2001;19:305–313
  5. Seydel HG, Leichman L, Byhardt R, Cooper J, Herskovic A, Libnock J, et al. Preoperative radiation and chemotherapy for localized squamous cell carcinoma of the esophagus: a RTOG Study. Int J Radiat Oncol Biol Phys. 1988;14:33–35
  6. Rizk NP, Venkatraman E, Bains MS, Park B, Flores R, Tang L, et al. American Joint Committee on Cancer. American Joint Committee on Cancer staging system does not accurately predict survival in patients receiving multimodality therapy for esophageal adenocarcinoma. J Clin Oncol. 2007;25:507–512
  7. Donahue JM, Nichols F, Li Z, Schomas DA, Allen MS, Cassivi SD, et al. Complete pathologic response after neoadjuvant chemoradiotherapy for esophageal cancer is associated with enhanced survival. Ann Thorac Surg. 2009;87:392–398discussion 398–399
  8. Luu TD, Gaur P, Force SD, Staley CA, Mansour KA, Miller JI, et al. Neoadjuvant chemoradiation versus chemotherapy for patients undergoing esophagectomy for esophageal cancer. Ann Thorac Surg. 2008;85:1217–1223discussion 1223–1224
  9. Altorki N, Skinner D. Should en bloc esophagectomy be the standard of care for esophageal carcinoma?. Ann Surg. 2001;234:581–587
  10. Gu Y, Swisher S, Ajani JA, Correa AM, Hofstetter WL, Liao Z, et al. The number of lymph nodes with metastasis predicts survival in patients with esophageal or esophagogastric junction adenocarcinoma who receive preoperative chemoradiation. Cancer. 2006;106:1017–1025
  11. Trovo M, Bradley J, El Naqa I, Foster E, Meyers B, Govindan R, et al. Esophageal carcinoma with celiac nodal metastases: curative or palliative?. J Thorac Oncol. 2008;3:751–755
  12. Chirieac LR, Swisher S, Ajani JA, Komaki RR, Correa AM, Morris JS, et al. Posttherapy pathologic stage predicts survival in patients with esophageal carcinoma receiving preoperative chemoradiation. Cancer. 2005;103:1347–1355
  13. Lee PC, Port JL, Paul S, Stiles BM, Altorki NK. Predictors of long-term survival following resection of esophageal carcinoma with non-regional nodalmetastases. Ann Thorac Surg. In press.
  14. Rizzetto C, DeMeester S, Hagen JA, Peyre CG, Lipham JC, DeMeester TR. En bloc esophagectomy reduces local recurrence and improves survival compared with transhiatal resection after neoadjuvant therapy for esophageal adenocarcinoma. J Thorac Cardiovasc Surg. 2008;135:1228–1236
  15. Altorki NK, Zhou X, Stiles B, Port JL, Paul S, Lee PC, et al. Total number of resected lymph nodes predicts survival in esophageal cancer. Ann Surg. 2008;248:221–226
  16. Schwarz RE, Smith D. Clinical impact of lymphadenectomy extent in resectable esophageal cancer. J Gastrointest Surg. 2007;11:1384–1393discussion 1393–1394
  17. Peyre CG, Hagen J, DeMeester SR, Altorki NK, Ancona E, Griffin SM, et al. The number of lymph nodes removed predicts survival in esophageal cancer: an international study on the impact of extent of surgical resection. Ann Surg. 2008;248:549–556
  18. DeMeester SR. Adenocarcinoma of the esophagus and cardia: a review of the disease and its treatment. Ann Surg Oncol. 2006;13:12–30
  19. Bédard EL, Inculet R, Malthaner RA, Brecevic E, Vincent M, Dar R. The role of surgery and postoperative chemoradiation therapy in patients with lymph node positive esophageal carcinoma. Cancer. 2001;91:2423–2430
  20. Rice TW, Adelstein D, Chidel MA, Rybicki LA, DeCamp MM, Murthy SC, et al. Benefit of postoperative adjuvant chemoradiotherapy in locoregionally advanced esophageal carcinoma. J Thorac Cardiovasc Surg. 2003;126:1590–1596
  21. Cunningham D, Allum W, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, et al. MAGIC Trial Participants. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355:11–20

 Disclosures: None.

 Dr Christos was partially supported by the Clinical Translational Science Center (CTSC) (UL1-RR024996) grant.

PII: S0022-5223(09)01325-7

doi: 10.1016/j.jtcvs.2009.10.003

The Journal of Thoracic and Cardiovascular Surgery
Volume 139, Issue 2 , Pages 387-394 , February 2010