title: Pathological analysis of clinical target volume margin for radiotherapy in patients with esophageal and gastroesophageal junction carcinoma.
abstract: OBJECTIVE
  To clarify the radiotherapy clinical target volume (CTV) margin needed for esophageal squamous-cell carcinoma (SCC) and gastroesophageal junction (GEJ) adenocarcinoma.
  
  
  METHODS
  Surgical specimens of esophageal SCC (n = 34) and GEJ adenocarcinoma (n = 32) were prospectively collected and analyzed for microscopic spread along the esophagus and GEJ both proximally and distally from gross tumor and for lymph node (LN) metastasis.
  
  
  RESULTS
  For SCC, the mean microscopic spread beyond the gross tumor was 10.5 +/- 13.5 mm proximally (<30 mm in 32 of 34 cases) and 10.6 +/- 8.1 mm distally (<30 mm in 33 of 34 cases). For GEJ adenocarcinoma, the spread was 10.3 +/- 7.2 mm proximally (<30 mm in 29 of 29 cases) and 18.3 +/- 16.3 mm distally (<30 mm in 27 of 32 cases). The extent of microscopic spread of cancer was significantly associated with pathologic T stage (p = 0.012). LN metastases were observed in 12 (35%) of 34 patients with middle and lower esophageal SCC and 15 (47%) of 32 patients with GEJ adenocarcinoma.
  
  
  CONCLUSIONS
  The extent of microscopic spread within esophagus (recommended CTV margin) was <30 mm in about 94% of cases of esophageal cancer, except for distal microscopic spread in GEJ adenocarcinoma, in which 50 mm was needed to cover about 94% of cases.
authors.affiliation: Department of Radiation Oncology, Beijing University First Hospital, Beijing, P R China.
authors.forename: Xian-Shu
authors.initials: XS
authors.lastname: Gao
authors.forename: Xueying
authors.initials: X
authors.lastname: Qiao
authors.forename: Fengpeng
authors.initials: F
authors.lastname: Wu
authors.forename: Li
authors.initials: L
authors.lastname: Cao
authors.forename: Xianli
authors.initials: X
authors.lastname: Meng
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Dong
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Wang
authors.forename: Guodong
authors.initials: G
authors.lastname: Gao
authors.forename: Tsung-Teh
authors.initials: TT
authors.lastname: Wu
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Komaki
authors.forename: Joe Y
authors.initials: JY
authors.lastname: Chang
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D004943:Esophagogastric Junction / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed