Evidence map›Paper›PMID 42412141›Full record

ArticleEsophagus : official journal of the Japan Esophageal Society2026

Clinical diagnostic accuracy and lymph node metastasis patterns in clinical T1bN0M0 esophageal squamous cell carcinoma: a supplementary analysis of JCOG1409.

Motoo Nomura, Hiroya Takeuchi, Masahiko Ando, Yasuhiro Tsubosa, Hirotoshi Kikuchi, Hirofumi Kawakubo, Kazuhiro Noma, Masaki Ueno, Takahiro Tsushima, Takeo Bamba and 11 more

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Article in Esophagus : official journal of the Japan Esophageal Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

The trial behind it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

21 authors.

Motoo NomuraDepartment of Clinical Oncology, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan. excell@hkg.odn.ne.jp.ORCID http://orcid.org/0000-0002-5967-0610
Hiroya TakeuchiDepartment of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
Masahiko AndoNagoya University Hospital, Nagoya, Japan.
Yasuhiro TsubosaDivision of Esophageal Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
Hirotoshi KikuchiDepartment of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
Hirofumi KawakuboDepartment of Surgery, Keio University School of Medicine, Tokyo, Japan.
Kazuhiro NomaDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan.
Masaki UenoGastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
Takahiro TsushimaDivision of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan.
Takeo BambaDepartment of Digestive Surgery, Niigata Cancer Center Hospital, Niigata, Japan.
Takeo FujitaDepartment of Esophageal Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
Yoichi HamaiDepartment of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
Tomokazu KakishitaDepartment of Gastroenterological Surgery, National Hospital Organization, Shikoku Cancer Center, Matsuyama, Japan.
Hiroyuki DaikoDepartment of Esophageal Surgery, National Cancer Center Hospital, Tokyo, Japan.
Kazuo KoyanagiDepartment of Gastroenterological Surgery, Tokai University School of Medicine, Isehara, Japan.
Satoru MatsudaDepartment of Surgery, Keio University School of Medicine, Tokyo, Japan.
Ken KatoDepartment of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
Keita SasakiJCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan.
Tetsuya SekitaJCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan.
Ryunosuke MachidaJCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan.
Yuko KitagawaDepartment of Surgery, Keio University School of Medicine, Tokyo, Japan.

Funding

Japan Agency for Medical Research and Development JP15ck0106190Japan Agency for Medical Research and Development JP18ck0106430Japan Agency for Medical Research and Development JP21ck0106668Japan Agency for Medical Research and Development JP24ck0106928
6 · The paper itself

Abstract

backgroundAccording to the results of JCOG0502, esophagectomy and chemoradiotherapy are standard treatments for cT1bN0M0 esophageal squamous cell carcinoma (ESCC). In the trial, 27.0% of patients developed pathological lymph node metastases (LNM). As imaging has advanced, diagnostic accuracy may have improved as well. This supplementary analysis of JCOG1409 aimed to clarify the clinical diagnostic accuracy, including the lymph node metastasis-positive proportion and lymph node metastasis sites, for clinical T1bN0M0 ESCC.

methodsData from JCOG1409, which compared thoracoscopic and open esophagectomy for ESCC, were analyzed, focusing on patients with cT1bN0M0 disease. All patients underwent esophagectomy with D2 or greater lymph node dissection, and none received neoadjuvant treatment. Pathologic findings, including the pathologic tumor depth of the primary tumor, station, and frequencies of LNM, were assessed.

resultsA total of 89 patients were included in this analysis. The diagnosis of pT1b was 66.3% (59/89 patients). For N-stage accuracy, 17 (19.1%) of the 89 clinical N0 patients had pathologic LNM. LNM was confined to the cervical and upper mediastinal regions in upper thoracic tumors, and to the upper mediastinal and abdominal regions in lower thoracic tumors. Conversely, middle thoracic tumors exhibited widespread multi-field LNM.

conclusionThe clinical diagnosis of T1bN0M0 is still not accurate, although the diagnostic accuracy for LNM in JCOG1409 improved compared to that in JCOG0502.

Indexed as

ChemoradiotherapyEsophageal cancerSurgery

Identifiers

PMID42412141

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.