ArticleAnnals of surgery2018
Impact of Extracapsular Lymph Node Involvement After Neoadjuvant Chemoradiation Therapy Followed by Surgery in Carcinoma of the Esophagus: A Multicenter Study.
Article in Annals of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Extranodal extension of nodal metastases is a poor prognostic moderator in non-small cell lung cancer: a meta-analysis.Virchows Archiv : an international journal of pathology · 2018Pooled it
- Risk Stratification of Postoperative Recurrence After Adjuvant Nivolumab for Resected Locally Advanced Esophageal Cancer: A Real-World Study.Annals of surgical oncology · 2026Article
- Clinical outcomes of adjuvant nivolumab following neoadjuvant chemotherapy and esophagectomy in patients with esophageal cancer: A single-center retrospective cohort study.Surgery today · 2026Article
- Evaluating Organotrophic Risk Factors, Time to Development, and Outcomes of Solitary Brain Metastasis After Esophagectomy: A Multicenter Cohort Study.Annals of surgical oncology · 2026Article
- Long-Term Survival of Two Versus Three Courses of Preoperative Cisplatin and Fluorouracil Plus Docetaxel for Locally Advanced Esophageal Cancer: A Multicenter Randomized Phase II Trial.Annals of gastroenterological surgery · 2025Article
- Survival Impact of Adjuvant Nivolumab Therapy for Locally Advanced Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemotherapy with Docetaxel Plus 5-Fluorouracil and Cisplatin.Annals of surgical oncology · 2025Article
- Impact of Extracapsular Extension of Lymph Node in Adenocarcinoma of the Stomach.Annals of surgical oncology · 2020Article
- Impact of Extracapsular Lymph Node Involving the Esophagus in Esophageal Perforation During and After Radiotherapy: A Propensity Score-Matched Analysis.Cancer management and research · 2020Article
- The significance of pathological extracapsularJournal of thoracic disease · 2018Article
- Extracapsular lymph node involvement after neoadjuvant chemoradiation in esophageal carcinoma: how to interpret?Journal of thoracic disease · 2017Article
- Extracapsular lymph node involvement in patients with esophageal cancer treated with neoadjuvant chemoradiation therapy followed by surgery: the closer you look, the less you see.Journal of thoracic disease · 2017Article
- Extranodal extension of nodal metastasis is the main prognostic moderator in squamous cell carcinoma of the esophagus after neoadjuvant chemoradiotherapy.Journal of thoracic disease · 2017Article
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11 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe current study aims to examine the impact of extracapsular lymph node involvement (EC-LNI) on survival for both esophageal adenocarcinoma (AC) and squamous cell carcinoma (SCC) treated with neoadjuvant chemoradiation therapy (nCRT) followed by surgery.
backgroundStudies have demonstrated the negative prognostic value of EC-LNI in primary surgery, but its impact after nCRT remains unclear.
methodsFrom the databases of 6 European high-volume centers 1505 patients with R0 resections were withheld. Oncologic variables, including ypT, ypN, number of positive lymph nodes, and lymph node capsular status: EC-LNI and intracapsular lymph node involvement (IC-LNI), were examined. Statistical analysis was performed by Cox proportional hazards modeling.
resultsIn SCC 182 patients (31.6%) had positive lymph nodes, of whom 60 (33.0%) showed EC-LNI. In AC 391 patients (42.1%) had positive lymph nodes, of whom 147 (37.6%) showed EC-LNI. Overall 5-year survival (O5YS) in SCC was 42.0%. Presence of EC-LNI meant a significantly worse O5YS than IC-LNI or pN0 (10.6%, 39.5%, and 47.4%, respectively; P < 0.05). O5YS in AC was 41.2%. No significant difference was observed between EC-LNI and IC-LNI (P = 0.322). In the multivariate analysis, among the examined possible prognosticators, presence of EC-LNI showed the highest hazard ratio (2.29, confidence interval: 1.52-3.47) as an independent prognosticator for overall survival in SCC, but it was not in AC.
conclusionsBased on this international multicenter study, the presence of EC-LNI after nCRT is at least as important as N-stage for survival and EC-LNI is the strongest prognosticator for overall survival in SCC but not in AC.
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