Ann Thorac Surg 2016 101:1075–80 Discussion 1080.Why would lymph nodes be swollen without cancer? Survival in patients with esophageal adenocarcinoma undergoing trimodality therapy is independent of regional lymph node location. Sepesi B, Schmidt HE, Lada M, Correa AM, Walsh GL, Mehran RJ, et al. International variation in surgical practices in units performing oesophagectomy for oesophageal cancer: a unit survey from the oesophago-gastric anastomosis audit (OGAA). Oesophago-Gastric Anastomosis Study Group on behalf of the West Midlands Research C. Frequency and implications of paratracheal lymph node metastases in resectable esophageal or gastroesophageal junction adenocarcinoma. Harada K, Hwang H, Wang X, Abdelhakeem A, Iwatsuki M, Blum Murphy MA, et al. Prophylactic cervical lymph node dissection in thoracoscopic esophagectomy for esophageal cancer increases postoperative complications and does not improve survival. Koterazawa Y, Oshikiri T, Takiguchi G, Hasegawa H, Yamamoto M, Kanaji S, et al. Radical lymph node dissection for cancer of the thoracic esophagus. All rights reserved.Īkiyama H, Tsurumaru M, Udagawa H, Kajiyama Y. Additional investigations in the form of endobronchial ultrasound are effective at providing additional staging information, and can substantially influence patient care.Ĭopyright © 2021 Wolters Kluwer Health, Inc. Nonregional clinically indeterminate lymph nodes represent a diagnostic dilemma in oesophageal cancer staging. Further investigations in this context are of value in this cohort and should be pursued. None had pathology suggesting false-negative lymph node sampling.ĮBUS and US-FNA are effective means of sampling clinically indeterminate nonregional lymph nodes, and can significantly impact prognosis, and management. Outcomes for patients who proceeded to surgery were similar to other cohorts. 15/18 (83.3%) of samples were benign and proceeded to surgery. The indeterminate lymph nodes were successfully sampled via endobronchial ultrasound (EBUS) or ultrasound-guided fine-needle aspiration (US-FNA) in 100% of cases.

Of these, 18 (23%) were deemed to have disease and performance status potentially amenable to radical surgery and underwent further assessment. A total of 79 patients met the inclusion criteria. Reports for 1189 PET-CT scans were reviewed. Subsequent work-up, management and outcomes were retrieved from electronic health records. Patients with mid- or distal oesophageal cancer with nonregional FDG avid nodes were identified. This study investigates the incidence, work-up and clinical significance of nonregional clinically indeterminate FDG avid lymph nodes.Ī single-centre retrospective review of all FDG PET-CT scans conducted over 5 years was conducted. The management of nonregional lymph nodes which appear indeterminate on CT and FDG PET-CT (subcentimeter nodes or those with preserved normal morphology, but increased FDG avidity) can present a diagnostic dilemma.

Metastatic involvement of nonregional supraclavicular or superior mediastinal lymph nodes in distal oesophageal cancer is rare but has important implications for prognosis and management.

Shotty paraesophageal lymph node