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Relationship Between the Size of Metastatic Lymph Nodes and Positron Emission Tomographic/Computer Tomographic Findings in Patients with Esophageal Squamous Cell Carcinoma.

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dc.contributor.authorPark, SY-
dc.contributor.authorKim, DJ-
dc.contributor.authorJung, HS-
dc.contributor.authorYun, MJ-
dc.contributor.authorLee, JW-
dc.contributor.authorPark, CK-
dc.date.accessioned2017-06-14T06:30:07Z-
dc.date.available2017-06-14T06:30:07Z-
dc.date.issued2015-
dc.identifier.issn0364-2313-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/14173-
dc.description.abstractBACKGROUND: We measured the sizes of metastatic lymph nodes and the relationships thereof by (18)F-fluorodeoxyglucose positron emission tomography/computer tomography (PET/CT). We identified risk factors for nodal upstaging in patients with esophageal squamous cell carcinoma (ESCC).

METHODS: Eighty-five patients with ESCC who underwent esophagectomy with extensive mediastinal lymphadenectomy were assessed. Two radiologists blinded to pathology data reviewed PET/CT scans, evaluating both primary tumors and lymph node involvement. A pathologist examined all metastatic lymph nodes in terms of maximal diameter (LNmax), the size of the metastatic focus (Fmax), and the metastasis occupation ratio (MOR = Fmax/LNmax).

RESULTS: The maximal tumor length averaged 2.9 ± 0.2 cm and the mean SUVmax of the primary lesion 5.3 ± 0.5. On PET/CT scans, 26 (30.6 %) patients exhibited nodal metastasis and 59 (69.4 %) did not. Pathology grades of pN0, pN1, pN2, and pN3 were assigned to 45 (52.9 %), 24 (28.2 %), 13 (15.3 %), and 3 (3.5 %) patients, respectively. Nodal upstaging was evident in 29 (34.1 %) cases. In 123 metastatic nodes of 4212 nodes dissected, the LNmax was 6.60 ± 0.39 mm, the Fmax 4.47 ± 0.35 mm, and the MOR 0.68 ± 0.03. Of 123 nodes, 85 (69.1 %) were retrieved from PET-negative stations, and the LNmax and Fmax values of these nodes were 5.88 ± 0.42 and 3.75 ± 0.31 mm, respectively. Upon multivariate analysis, tumor length (OR 1.666, p = 0.019) and lymphovascular invasion (OR 41.038, p < 0.001) were risk factors for nodal upstaging.

CONCLUSION: A significant proportion of nodal metastases were too small to detect via PET/CT imaging. Therefore, meticulous lymph node dissection might be helpful in ESCC patients.
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dc.language.isoen-
dc.subject.MESHBlood Vessels-
dc.subject.MESHCarcinoma, Squamous Cell-
dc.subject.MESHEsophageal Neoplasms-
dc.subject.MESHEsophagectomy-
dc.subject.MESHFemale-
dc.subject.MESHFluorodeoxyglucose F18-
dc.subject.MESHHumans-
dc.subject.MESHLymph Node Excision-
dc.subject.MESHLymph Nodes-
dc.subject.MESHLymphatic Metastasis-
dc.subject.MESHLymphatic Vessels-
dc.subject.MESHMale-
dc.subject.MESHMediastinum-
dc.subject.MESHMiddle Aged-
dc.subject.MESHMultimodal Imaging-
dc.subject.MESHNeoplasm Grading-
dc.subject.MESHNeoplasm Invasiveness-
dc.subject.MESHNeoplasm Staging-
dc.subject.MESHPositron-Emission Tomography-
dc.subject.MESHRadiopharmaceuticals-
dc.subject.MESHRisk Factors-
dc.subject.MESHTomography, X-Ray Computed-
dc.subject.MESHTumor Burden-
dc.titleRelationship Between the Size of Metastatic Lymph Nodes and Positron Emission Tomographic/Computer Tomographic Findings in Patients with Esophageal Squamous Cell Carcinoma.-
dc.typeArticle-
dc.identifier.pmid26324159-
dc.contributor.affiliatedAuthor박, 성용-
dc.type.localJournal Papers-
dc.identifier.doi10.1007/s00268-015-3221-3-
dc.citation.titleWorld journal of surgery-
dc.citation.volume39-
dc.citation.number12-
dc.citation.date2015-
dc.citation.startPage2948-
dc.citation.endPage2954-
dc.identifier.bibliographicCitationWorld journal of surgery, 39(12). : 2948-2954, 2015-
dc.identifier.eissn1432-2323-
dc.relation.journalidJ003642313-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Thoracic & Cardiovascular Surgery
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