Pattern of lymph node metastases and its implication in radiotherapeutic clinical target volume in patients with thoracic esophageal squamous cell carcinoma: A report of 1077 cases

被引：72
作者：
Huang, Wei [1 ,2 ]
Li, Baosheng [1 ]
Gong, Heyi [1 ,2 ]
Yu, Jinming [1 ]
Sun, Hongfu [1 ]
Zhou, Tao [1 ]
Zhang, Zicheng [1 ]
Liu, Xibin
机构：
[1] Shandong Canc Inst Hosp, Dept Radiat Oncol Chest Sect, Jinan 250117, Shandong, Peoples R China
[2] Tianjin Med Univ, Canc Inst Hosp, Tianjin, Peoples R China
来源：
RADIOTHERAPY AND ONCOLOGY | 2010年 / 95卷 / 02期
关键词：
Esophageal cancer; Conformal radiotherapy; Target volume; INTENSITY-MODULATED TECHNIQUES; EXTENDED ESOPHAGECTOMY; ENDOSCOPIC ULTRASOUND; CANCER; DISSECTION; CHEMORADIATION; RECURRENCE; PROGNOSIS; SURVIVAL; SURGERY;
D O I：
10.1016/j.radonc.2010.01.006
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
Purpose: To study the pattern of lymph node metastases after esophagectomy and clarify the clinical target volume (CTV) delineation of thoracic esophageal squamous cell carcinoma (ESCC). Methods and materials: Total 1077 thoracic ESCC patients who had undergone esophagectomy and lymphadenectomy were retrospectively examined. The clinicopathologic factors related to lymph node metastasis were analyzed using logistic regression analysis. Results: The rates of lymph node metastases in patients with upper thoracic tumors were 16.7% (9/54) cervical, 38.9% (18/54) upper mediastinal, 11.1% (6/54) middle mediastinal, 5.6% (3/54) lower mediastinal, and 5.6% (3/54) abdominal, respectively. The rates of lymph node metastases in patients with middle thoracic tumors were 4.0% (27/680), 3.8% (26/680), 32.9% (224/680), 7.1% (48/680), and 17.1% (116/680), respectively. The rates of lymph node metastases in patients with lower thoracic tumors were 1.0% (5/343), 3.0% (10/343), 22.7% (78/343), 37.0% (127/343), and 33.2% (114/343), respectively. T stage, the length of tumor and the histological differentiation emerged as statistically significant risk factors of lymph node metastases of thoracic ESCC (P < 0.001). Conclusions: T stage, the length of tumor and the histologic differentiation influence the pattern of lymph node metastases in thoracic ESCC. These factors should be considered comprehensively to design the CTV for radiotherapy (RT) of thoracic ESCC. Selective regional irradiation including the correlated lymphatic drainage regions should be performed as well. (C) 2010 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 95 (2010) 229-233
引用
收藏
页码：229 / 233
页数：5
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