AI Article Synopsis
- Patients with extensive N3 lymph node metastases from esophageal cancer face a poor overall survival, with a median of only 12.5 months, signaling the need for better treatment strategies.
- In a study of 359 patients with cN3M0 disease, those who underwent surgery after chemotherapy showed improved survival rates, with a median of 23.7 months compared to 13.3 months for those treated only with chemoradiotherapy.
- The research highlights the challenges in accurately staging N3 esophageal cancer and suggests that surgical intervention may enhance survival outcomes, emphasizing the need for further studies in this area.
Article Abstract
Background: Patients with extensive lymph node metastases have a poor prognosis. Clinical staging of lymph node metastases poses significant challenges given the limited sensitivity and specificity of imaging techniques. The aim of this study was to investigate the overall survival (OS) of patients with N3 disease in a real-world Dutch population and the added value of surgery in these patients.
Methods: Patients with cN3M0 esophageal or gastroesophageal cancer were identified from the Netherlands Cancer Registry (2012-2019). Treatment consisted of neoadjuvant chemo(radio)therapy followed by resection or chemo(radio)therapy, radiotherapy, or esophagectomy alone. OS was calculated using the Kaplan-Meier method.
Results: Some 21,566 patients were diagnosed with esophageal cancer of whom 359 (1.7%) had cN3M0 disease. Median OS of these patients was 12.5 months (95% CI: 10.7-14.3). Median OS following chemoradiotherapy alone and neoadjuvant therapy plus surgery was 13.3 months (95% CI: 10.7-15.9) and 23.7 months (95% CI: 18.3-29.2), respectively. Of all patients who underwent esophagectomy, 391 (2.8%) had (y)pN3 disease, and median OS was 16.1 months (95% CI: 14.8-17.4). Twenty-one patients (5.4%) were correctly classified as cN3, and 3-year OS was 21%.
Conclusion(s): Clinical staging appears to be difficult, apparently in patients with N3 esophageal cancer. Surgery seems to be of benefit to these patients. More research is required to address the ongoing challenges in clinical staging and the best neoadjuvant therapy.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11382634 | PMC |
| http://dx.doi.org/10.1159/000540468 | DOI Listing |
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