Esophageal Cancer: Associations With (pN+) Lymph Node Metastases.

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• dc.contributor.author Rice, Thomas W.ca
• dc.contributor.author Pera Roman, Manuel Ramónca
• dc.contributor.author Blackstone, Eugene H.ca
• dc.date.accessioned 2017-03-21T12:26:29Z
• dc.date.issued 2017
• dc.description.abstract OBJECTIVES: To identify the associations of lymph node metastases (pN+), number of positive nodes, and pN subclassification with cancer, treatment, patient, geographic, and institutional variables, and to recommend extent of lymphadenectomy needed to accurately detect pN+ for esophageal cancer. SUMMARY BACKGROUND DATA: Limited data and traditional analytic techniques have precluded identifying intricate associations of pN+ with other cancer, treatment, and patient characteristics. METHODS: Data on 5806 esophagectomy patients from the Worldwide Esophageal Cancer Collaboration were analyzed by Random Forest machine learning techniques. RESULTS: pN+, number of positive nodes, and pN subclassification were associated with increasing depth of cancer invasion (pT), increasing cancer length, decreasing cancer differentiation (G), and more regional lymph nodes resected. Lymphadenectomy necessary to accurately detect pN+ is 60 for shorter, well-differentiated cancers (<2.5 cm) and 20 for longer, poorly differentiated ones. CONCLUSIONS: In esophageal cancer, pN+, increasing number of positive nodes, and increasing pN classification are associated with deeper invading, longer, and poorly differentiated cancers. Consequently, if the goal of lymphadenectomy is to accurately define pN+ status of such cancers, few nodes need to be removed. Conversely, superficial, shorter, and well-differentiated cancers require a more extensive lymphadenectomy to accurately define pN+ status.ca
• dc.format.mimetype application/pdfca
• dc.identifier.citation Rice TW, Ishwaran H, Hofstetter WL, Schipper PH, Kesler KA, Law S. et al. Esophageal Cancer: Associations With (pN+) Lymph Node Metastases. Ann Surg. 2017 Jan;265(1):122-129. doi: 10.1097/SLA.0000000000001594ca
• dc.identifier.doi http://dx.doi.org/10.1097/SLA.0000000000001594
• dc.identifier.issn 0003-4932
• dc.identifier.uri http://hdl.handle.net/10230/28271
• dc.language.iso engca
• dc.publisher Lippincott Williams & Wilkinsca
• dc.relation.ispartof Annals of Surgery. 2017 Jan;265(1):122-9
• dc.rights © Lippincott Williams & Wilkins "This is a non-final version of an article published in final form inRice TW, Ishwaran H, Hofstetter WL, Schipper PH, Kesler KA, Law S. et al. Esophageal Cancer: Associations With (pN+) Lymph Node Metastases. Ann Surg. 2017 Jan;265(1):122-129". http://dx.doi.org/10.1097/SLA.0000000000001594ca
• dc.rights.accessRights info:eu-repo/semantics/embargoedAccessca
• dc.subject.other Esòfag -- Càncerca
• dc.title Esophageal Cancer: Associations With (pN+) Lymph Node Metastases.ca
• dc.type info:eu-repo/semantics/articleca
• dc.type.version info:eu-repo/semantics/acceptedVersionca