Detection of lymph node metastases in esophageal cancer

2011 ◽  
Vol 11 (4) ◽  
pp. 601-612 ◽  
Author(s):  
George Sgourakis ◽  
Ines Gockel ◽  
Orestis Lyros ◽  
Torsten Hansen ◽  
Peter Mildenberger ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Node Metastases

PS02.084: PROSPECTIVE EVALUATION OF 18F-FDG PET-CT AFTER NEOADJUVANT CHEMORADIOTHERAPY FOR DETECTING LYMPH NODE METASTASES NEAR THE CELIAC TRUNK IN PATIENTS WITH ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 144-144
Author(s):  
Jasper Groen ◽  
Suzanne Gisbertz ◽  
Mark I Van Berge Henegouwen ◽  
Annelijn E Slaman ◽  
Sybren Meijer ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Predictive Value ◽  
Neoadjuvant Chemoradiotherapy ◽  
Celiac Trunk ◽  
Pet Ct ◽  
Resection Specimen ◽  
Node Metastases ◽  
18F Fdg

Abstract Background Celiac trunk metastases are an independent factor for inferior survival in patients with esophageal cancer. Detecting these metastases before esophagostomy would aid clinical decision making. The aim of our study was to evaluate the accuracy of integrated PET and CT (PET-CT) using 18F-FDG in detecting these metastases in patients with esophageal cancer after neoadjuvant chemoradiotherapy (nCRTx) followed by esophagectomy. Methods All patients with a carcinoma of the mid-to-distal esophagus or the gastroesophageal junction (GEJ) who underwent esophageal resection with curative intent following nCRTx between January 2011 and January 2017 were included. The PET-CT scans after nCRTx were reviewed by nuclear radiologists and lymph nodes within a margin of 2 cm around the celiac trunk were expressed in SUVmax. Lymph nodes with SUVmax > 2.0 were deemed positive. The truncal nodes were extracted during esophagectomy and reviewed by different pathologists using standard pathology protocol. To assess the accuracy of the PET-CT in detecting lymph node metastases near the celiac trunk the sensitivity, specificity and positive and negative predictive value were calculated. Results A total of 448 patients were included. There were 24 patients (5.4%) with positive truncal nodes on the PET-CT versus 424 patients (90.6%) with negative truncal nodes on the PET-CT. Out of these 24 patients 20 (83.3%) had truncal node metastases confirmed in the resection specimen (positive predictive value of 83.3%). In the other 424 patients 40 (9.4%) had truncal node metastases confirmed in the resection specimen (negative predictive value of 90.6%). This results in a sensitivity of 33.3% and a specificity of 99.0%. Conclusion The sensitivity and specificity of the PET-CT in detecting lymph node metastases near the celiac trunk in patients with esophageal cancer who underwent nCRTx were respectively 33.3% and 99.0% This shows that the PET-CT is accurate in detecting truncal lymph node metastases in this patient group. Disclosure All authors have declared no conflicts of interest.

Dissection of lymph node metastases in esophageal cancer

2011 ◽  
Vol 11 (4) ◽  
pp. 571-578 ◽  
Author(s):  
Ines Gockel ◽  
George Sgourakis ◽  
Orestis Lyros ◽  
Torsten Hansen ◽  
Hauke Lang
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Node Metastases

The number of lymph node metastases influences survival in esophageal cancer

1998 ◽  
Vol 67 (3) ◽  
pp. 160-163 ◽  
Author(s):  
Katsunobu Kawahara ◽  
Takahumi Maekawa ◽  
Kan Okabayashi ◽  
Takeshi Shiraishi ◽  
Yasuteru Yoshinaga ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Node Metastases

W1668 High Prevalence of Lymph Node Metastases in pT1 Esophageal Cancer: Is Local Therapy Justified?

2008 ◽  
Vol 134 (4) ◽  
pp. A-903
Author(s):  
Ines Gockel ◽  
Torsten Hansen ◽  
Faszillo S. Sultanov ◽  
Tran T. Trinh ◽  
Mario Domeyer ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Local Therapy ◽  
High Prevalence ◽  
Node Metastases

Plasma DNA: A molecular marker for the pattern of dissemination of esophageal cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21015-21015
Author(s):  
F. Banki ◽  
J. A. Hagen ◽  
R. J. Mason ◽  
S. R. DeMeester ◽  
D. Oh ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Molecular Marker ◽  
Lymph Node Metastases ◽  
Normal Subjects ◽  
Molecular Diagnostic ◽  
Plasma Dna ◽  
Hematogenous Spread ◽  
Additional Increase ◽  
Node Metastases

21015 Background: We previously showed that free DNA is present in blood of normal subjects and that the plasma DNA level is higher in patients with esophageal cancer compared to normal subjects. These observations suggest that the plasma DNA level may be a useful molecular marker in the diagnosis of esophageal cancer. We hypothesize that lymphatic and hematogenous spread may result in different plasma DNA levels despite both representing advanced disease. Our aim was to measure and compare plasma DNA levels in normal subjects, patients with localized esophageal cancer, patients with lymph node metastases, and patients with hematogenous spread to solid organs (systemic metastases). Methods: Plasma DNA was measured using PCR in 44 normal subjects, 25 patients with localized esophageal cancer (T1–3, N0, M0), 18 patients with lymph node metastases, and 7 patients with systemic metastases. Results: The 95th percentile of plasma DNA level in normal subjects was 19 ng/ml. The median plasma DNA levels were higher in all 3 groups of patients with esophageal cancer compared to control subjects. While there was no difference between the plasma DNA level in patients with localized esophageal cancer and those with lymph node metastases (median of 5 nodes involved, range: 1–31), patients with systemic metastases had a significantly higher level of plasma DNA compared to patients with lymph node metastases and those with localized esophageal cancer. Conclusion: Plasma DNA levels are elevated in patients with esophageal cancer, whether localized or associated with lymph node metastases. In patients with systemic metastases, a significant additional increase in the plasma DNA level occurs. This suggests that measuring the plasma DNA level is a useful molecular diagnostic tool for detection of disseminated esophageal cancer. [Table: see text] No significant financial relationships to disclose.

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