Background and Study Aims: The management of patients with esophageal cancer with malignant celiac lymph nodes (CLNs) is controversial. In this study we evaluated the management and survival of patients with positive ...Background and Study Aims: The management of patients with esophageal cancer with malignant celiac lymph nodes (CLNs) is controversial. In this study we evaluated the management and survival of patients with positive CLN findings on endoscopic ultrasonography (EUS) and compared the outcome in surgically treated patients with that of nonsurgically treated patients. Patients and Methods: The EUS database of the Academic Medical Center was retrospectively searched for patients with esophageal carcinoma and EUS-positive CLN. Follow-up comprised the review of medical charts and contact with general practitioners. Results: From 1993 through 2000, 78 patients with esophageal carcinoma and suspicious CLN were eligi ble for inclusion in this study. The median survival of patients with CLN size < 2 cm was 13.5 months vs. 7.0 months for patients with CLN size >2 cm (P = 0.01) . In a multivariate model, CLN size was the only predictive factor for poor pati ent survival. Of the 78 study patients, 13 underwent a surgical resection and 65 received nonsurgical treatment. The surgical group was significantly younger an dall patents in this group had CLN size < 2 cm. The median survival for the surgical group was 13.7 months vs. 13.5 months for the nonsurgical group with CLN s ize < 2 cm (P = 0.63). Conclusions: In this retrospective study, CLN size was a significant predictor for poor survival. The surgically treated patients had a mediumterm survival similar to that of nonsurgically treated patients with a CLN size < 2 cm. These findings underline the prognostic value of CLN size in patien ts with esophageal carcinoma.展开更多
文摘Background and Study Aims: The management of patients with esophageal cancer with malignant celiac lymph nodes (CLNs) is controversial. In this study we evaluated the management and survival of patients with positive CLN findings on endoscopic ultrasonography (EUS) and compared the outcome in surgically treated patients with that of nonsurgically treated patients. Patients and Methods: The EUS database of the Academic Medical Center was retrospectively searched for patients with esophageal carcinoma and EUS-positive CLN. Follow-up comprised the review of medical charts and contact with general practitioners. Results: From 1993 through 2000, 78 patients with esophageal carcinoma and suspicious CLN were eligi ble for inclusion in this study. The median survival of patients with CLN size < 2 cm was 13.5 months vs. 7.0 months for patients with CLN size >2 cm (P = 0.01) . In a multivariate model, CLN size was the only predictive factor for poor pati ent survival. Of the 78 study patients, 13 underwent a surgical resection and 65 received nonsurgical treatment. The surgical group was significantly younger an dall patents in this group had CLN size < 2 cm. The median survival for the surgical group was 13.7 months vs. 13.5 months for the nonsurgical group with CLN s ize < 2 cm (P = 0.63). Conclusions: In this retrospective study, CLN size was a significant predictor for poor survival. The surgically treated patients had a mediumterm survival similar to that of nonsurgically treated patients with a CLN size < 2 cm. These findings underline the prognostic value of CLN size in patien ts with esophageal carcinoma.
