There is increasing evidence to include combined neoadjuvant chemoradiotherapy (CRT) as an alternative to surgical resection alone, to improve survival for locoregional esophageal cancer. More recently, attention has focused on the presence of extracapsular lymph node involvement (LNI), which identifies a subgroup of patients with significantly worse long-term survival. Little is known about the effects of neoadjuvant chemoradiotherapy (CRT) on the presence of extracapsular LNI and its prognostic value in patients with resected esophageal cancer.
A research article to be published in April 28, 2010 in the World Journal of Gastroenterology addresses this question. The research team, led by Dr. Metzger R and Dr. Hölscher AH from the Department of General, Visceral, and Cancer Surgery, Center for Integrated Oncology, University of Cologne, Germany investigated the effects of neoadjuvant CRT on the presence of extracapsular LNI and its prognostic value in patients with resected esophageal cancer. Two hundred and ninety-eight patients with advanced esophageal cancer underwent esophagectomy, of whom 68.8% were treated with neoadjuvant CRT prior to resection. A total of 986 metastatic LNs were examined.
The results support the hypothesis that extracapsular LNI is not influenced by neoadjuvant CRT and identifies a subgroup of esophageal cancer patients with a significantly worse long-term survival. Therefore extracapsular LNI should be noted as a negative prognostic factor and should be taken into account for a revised staging system for esophageal cancer.
Reference: Metzger R, Bollschweiler E, Drebber U, Mönig SP, Schröder W, Alakus H, Kocher M, Baldus SE, Hölscher AH. Neoadjuvant chemoradiotherapy for esophageal cancer: Impact on extracapsular lymph node involvement. World J Gastroenterol 2010; 16(16): 1986-1992
Correspondence to: Ralf Metzger, MD, Department of General, Visceral and Cancer Surgery, Center for Integrated Oncology, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany. email@example.com
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About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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