BACKGROUND Thoracic para-aortic lymph node(TPLN)recurrence in esophageal squamous cell carcinoma(ESCC)is rare and its impact on survival is unknown.We studied survival in patients with ESCC who developed TPLN recurren...BACKGROUND Thoracic para-aortic lymph node(TPLN)recurrence in esophageal squamous cell carcinoma(ESCC)is rare and its impact on survival is unknown.We studied survival in patients with ESCC who developed TPLN recurrence.AIM To study the survival in patients with ESCC who developed TPLNs recurrence.METHODS Data were collected retrospectively for 219 patients who had undergone curative surgery for ESCC during January 2012 to November 2017 and who developed recurrences(36.29%of 604 patients who had undergone curative surgeries for ESCC).The patients were classified into positive(+)and negative(-)TPLN metastasis subgroups.We also investigated TPLN recurrence in 223 patients with ESCC following definitive chemoradiotherapy during 2012-2013.Following propensity score matching(PSM)and survival estimation,factors predictive of overall survival(OS)were explored using a Cox proportional hazards model.RESULTS Among the patients with confirmed recurrence,18 were TPLN(+)and 13 developed synchronous distant metastases.Before PSM,TPLN(+)was associated with worse recurrence-free(P=0.00049)and OS[vs TPLN(-);P=0.0027],whereas only the intergroup difference in recurrence-free survival remained significant after PSM(P=0.013).The Cox analysis yielded similar results.Among the patients who had received definitive chemoradiotherapy,3(1.35%)had preoperative TPLN enlargement and none had developed recurrences.CONCLUSION TPLN metastasis is rare but may be associated with poor survival.展开更多
Despite recent progress in diagnostic imaging,gastric cancer(GC)is occasionally found at an advanced stage with distant metastasis.As metastatic GC is difficult to cure,the treatment strategy should be considered indi...Despite recent progress in diagnostic imaging,gastric cancer(GC)is occasionally found at an advanced stage with distant metastasis.As metastatic GC is difficult to cure,the treatment strategy should be considered individually based on the physical and socioeconomic status of patients as well as on the GC symptoms.The first choice of treatment for metastatic GC is chemotherapy,and several chemotherapeutic regimens for metastatic or recurrent GC have been developed through randomized controlled trials.Ongoing clinical trials will provide novel therapeutic options for patients with metastatic GC in the near future,while individualization of treatment based on detailed molecular information,so-called precision medicine,is eagerly anticipated.In this article,we review recent publications and guidelines focusing on recent progress in the treatment of metastatic GC in Japan.展开更多
文摘BACKGROUND Thoracic para-aortic lymph node(TPLN)recurrence in esophageal squamous cell carcinoma(ESCC)is rare and its impact on survival is unknown.We studied survival in patients with ESCC who developed TPLN recurrence.AIM To study the survival in patients with ESCC who developed TPLNs recurrence.METHODS Data were collected retrospectively for 219 patients who had undergone curative surgery for ESCC during January 2012 to November 2017 and who developed recurrences(36.29%of 604 patients who had undergone curative surgeries for ESCC).The patients were classified into positive(+)and negative(-)TPLN metastasis subgroups.We also investigated TPLN recurrence in 223 patients with ESCC following definitive chemoradiotherapy during 2012-2013.Following propensity score matching(PSM)and survival estimation,factors predictive of overall survival(OS)were explored using a Cox proportional hazards model.RESULTS Among the patients with confirmed recurrence,18 were TPLN(+)and 13 developed synchronous distant metastases.Before PSM,TPLN(+)was associated with worse recurrence-free(P=0.00049)and OS[vs TPLN(-);P=0.0027],whereas only the intergroup difference in recurrence-free survival remained significant after PSM(P=0.013).The Cox analysis yielded similar results.Among the patients who had received definitive chemoradiotherapy,3(1.35%)had preoperative TPLN enlargement and none had developed recurrences.CONCLUSION TPLN metastasis is rare but may be associated with poor survival.
文摘Despite recent progress in diagnostic imaging,gastric cancer(GC)is occasionally found at an advanced stage with distant metastasis.As metastatic GC is difficult to cure,the treatment strategy should be considered individually based on the physical and socioeconomic status of patients as well as on the GC symptoms.The first choice of treatment for metastatic GC is chemotherapy,and several chemotherapeutic regimens for metastatic or recurrent GC have been developed through randomized controlled trials.Ongoing clinical trials will provide novel therapeutic options for patients with metastatic GC in the near future,while individualization of treatment based on detailed molecular information,so-called precision medicine,is eagerly anticipated.In this article,we review recent publications and guidelines focusing on recent progress in the treatment of metastatic GC in Japan.
