caa a22 4500 445338814 CHVBK 20180317142805.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1245/s10434-011-1753-9 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1753-9 Nodal Metastasis From Locally Advanced Esophageal Cancer: How Neoadjuvant Therapy Modifies Their Frequency and Distribution [Elektronische Daten] [Carlo Castoro, Marco Scarpa, Matteo Cagol, Alberto Ruol, Francesco Cavallin, Rita Alfieri, Gianpietro Zanchettin, Massimo Rugge, Ermanno Ancona] Background: Neoadjuvant chemoradiotherapy (CT-RT) before esophagectomy seems to affect the number of nodal metastasis and to alter the distribution of those that remain. The aim of this study was to define how neoadjuvant chemoradiotherapy changes nodal metastasis patterns in locally advanced esophageal cancer. Methods: A total of 402 consecutive patients with cancer of the esophagus or esophagogastric junction (181 adenocarcinoma [AC] and 221 squamous cell carcinoma [SCC]) (evaluated at clinical stage T1N1, T2N1, T3N0, or T3N1 and pathological stage M0) presenting in our Department between 1992 and 2007 and who underwent complete resection (R0) were included in this retrospective study on a prospectively collected database. All dissected lymph nodes were retrieved and microscopically analyzed. Nodal metastasis patterns in patients who underwent chemotherapy (CT) or chemoradiotherapy (CT-RT) neoadjuvant therapy were compared with those in patients who underwent surgery alone. Results: Almost 30% of the adenocarcinoma patients and approximately 40% of the SCC patients showed effective tumor downstaging after neoadjuvant therapy. There were fewer paracardial node metastases (P=.002) in the AC patients who underwent CT-RT neoadjuvant therapy. There were, likewise, significantly fewer paraesophageal, paracardial, and subcarinal node metastases in the SCC patients in whom the perigastric nodes became the second-most frequent site of metastasis. Conclusion: Not only was frequency of lymph node metastases decreased after neoadjuvant therapy, but nodal localization and pattern were also significantly modified. Society of Surgical Oncology, 2011 Castoro Carlo Oncological Surgery Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy aut Scarpa Marco Oncological Surgery Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy aut Cagol Matteo Oncological Surgery Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy aut Ruol Alberto Department of Surgical and Gastroenterological Sciences, University of Padova, Padova, Italy aut Cavallin Francesco Oncological Surgery Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy aut Alfieri Rita Oncological Surgery Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy aut Zanchettin Gianpietro Department of Surgical and Gastroenterological Sciences, University of Padova, Padova, Italy aut Rugge Massimo Department of Pathology, University of Padova, Padova, Italy aut Ancona Ermanno Oncological Surgery Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy aut Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3743-3754 1068-9265 18:13<3743 2011 18 10434 https://doi.org/10.1245/s10434-011-1753-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1753-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Castoro Carlo Oncological Surgery Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy aut NATIONALLICENCE 700 1- Scarpa Marco Oncological Surgery Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy aut NATIONALLICENCE 700 1- Cagol Matteo Oncological Surgery Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy aut NATIONALLICENCE 700 1- Ruol Alberto Department of Surgical and Gastroenterological Sciences, University of Padova, Padova, Italy aut NATIONALLICENCE 700 1- Cavallin Francesco Oncological Surgery Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy aut NATIONALLICENCE 700 1- Alfieri Rita Oncological Surgery Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy aut NATIONALLICENCE 700 1- Zanchettin Gianpietro Department of Surgical and Gastroenterological Sciences, University of Padova, Padova, Italy aut NATIONALLICENCE 700 1- Rugge Massimo Department of Pathology, University of Padova, Padova, Italy aut NATIONALLICENCE 700 1- Ancona Ermanno Oncological Surgery Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3743-3754 1068-9265 18:13<3743 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer