title: Salvage lymphadenectomy for recurrent esophageal cancer after chemoradiotherapy.
abstract: Although salvage esophagectomies are widely performed, reports on salvage lymphadenectomy (SL) are few. We review our SL cases to clarify the indications. Fifty-five patients with esophageal cancer underwent chemoradiotherapy or radiotherapy, including 3 patients with single lymph node (LN) recurrences and one with allochronic double cervical node recurrence. Our department removed 5 recurrent LNs from these 4 patients. In Case 1, right supraclavicular LN was judged to be metastatic and R0 resection was carried out; he is alive without recurrence. In Case 2, we found, allochronically, metastases in his left cervical paraesophageal LN and left supraclavicular LN; residual tumors were R1 in both lesions. He is alive despite esophageal recurrence. In Case 3, a lymphadenectomy was performed on his thoracic para-aortic LN; however, tumor was removed incompletely, and he died 4 months after SL from disease progression. In Case 4, a subcarinal LN was thought to be metastatic, and was removed but no malignant tissues detected. He died 17 months after SL from pneumonia. Our experiences suggest that some patients survive relatively long with SL. Moreover, molecular examination of resected lesions could guide subsequent therapies. SL might be more widely used for these patients if not otherwise contraindicated.
authors: 1 Department of Surgery I, Dokkyo Medical University, Mibu, Shimotsuga-gun, Tochigi, Japan.
authors: Masanobu
authors: M
authors: Nakajima
authors: Yasushi
authors: Y
authors: Domeki
authors: Hitoshi
authors: H
authors: Satomura
authors: Masakazu
authors: M
authors: Takahashi
authors: Akira
authors: A
authors: Sugawara
authors: Hiroto
authors: H
authors: Muroi
authors: Kinro
authors: K
authors: Sasaki
authors: Satoru
authors: S
authors: Yamaguchi
authors: Tatsuya
authors: T
authors: Miyazaki
authors: Hiroyuki
authors: H
authors: Kuwano
authors: Hiroyuki
authors: H
authors: Kato
mesh_terms: D000368:Aged; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery*; D016879:Salvage Therapy; D016896:Treatment Outcome
keywords: Chemoradiotherapy; Esophageal cancer; Esophagectomy; Salvage surgery; salvage lymphadenectomy