title: Determination of the irradiation field for clinical T1-T3N0M0 thoracic/abdominal esophageal cancer based on the postoperative pathological results.
abstract: OBJECTIVE
  In patients with thoracic/abdominal esophageal cancer with no clinical evidence of lymph node metastasis, there is no consensus about whether the irradiation field should include regional lymph nodes. In this study, the extent of the irradiation field for clinical stage T1-3N0M0 esophageal cancer was determined based on the postoperative pathological results.
  
  
  METHODS
  From July 1989 to June 2008, 103 patients diagnosed with clinical stage T1-3N0M0 thoracic/abdominal esophageal cancer underwent standard esophagectomy and regional lymph node dissection at the Aichi Cancer Center Hospital. Of these 103 patients, the pathological results of the resected specimens could be confirmed in 95 (92%) patients. The pathological lymphatic spread was reviewed retrospectively, and the extent of the irradiation field was determined based on the postoperative pathological results.
  
  
  RESULTS
  Of 95 patients with clinical stage T1-3N0M0 esophageal cancer, 40 (42.1%) had pathological lymph node metastases, and the frequency of nodal metastases was studied by tumor location. The rates of lymph node metastases for the upper, middle, lower and abdominal esophagus were 37.5%, 32.5%, 46% and 70%, respectively.
  
  
  CONCLUSIONS
  Pathological lymph nodes metastases are often seen after operation in clinical stage T1-3N0M0 esophageal cancer. In the present study, the optimal lymph nodes to be included in the irradiation field were determined according to the primary site in the esophagus.
authors.affiliation: Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama City, Fukushima 963-8052, Japan. tatsuya.nakamura@nifty.com
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nakamura
authors.forename: Syunzo
authors.initials: S
authors.lastname: Hatooka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kodaira
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tachibana
authors.forename: Natsuo
authors.initials: N
authors.lastname: Tomita
authors.forename: Rie
authors.initials: R
authors.lastname: Nakahara
authors.forename: Haruo
authors.initials: H
authors.lastname: Inokuchi
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Mizoguchi
authors.forename: Akinori
authors.initials: A
authors.lastname: Takada
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shinoda
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Fuwa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging