Esophageal Cancer: Associations With (pN+) Lymph Node Metastases

Thomas W. Rice, Hemant Ishwaran, Wayne L. Hofstetter, Paul H. Schipper, Kenneth A. Kesler, Simon Law, E. M R Lerut, Chadrick E. Denlinger, Jarmo A. Salo, Walter J. Scott, Thomas J. Watson, Mark S. Allen, Long Qi Chen, Valerie W. Rusch, Robert J. Cerfolio, James D. Luketich, Andre Duranceau, Gail E. Darling, Manuel Pera, Carolyn Apperson-HansenEugene H. Blackstone

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Abstract

OBJECTIVES:: To identify the associations of lymph node metastases (pN+), number of positive nodes, and pN subclassification with cancer, treatment, patient, geographic, and institutional variables, and to recommend extent of lymphadenectomy needed to accurately detect pN+ for esophageal cancer. SUMMARY BACKGROUND DATA:: Limited data and traditional analytic techniques have precluded identifying intricate associations of pN+ with other cancer, treatment, and patient characteristics. METHODS:: Data on 5806 esophagectomy patients from the Worldwide Esophageal Cancer Collaboration were analyzed by Random Forest machine learning techniques. RESULTS:: pN+, number of positive nodes, and pN subclassification were associated with increasing depth of cancer invasion (pT), increasing cancer length, decreasing cancer differentiation (G), and more regional lymph nodes resected. Lymphadenectomy necessary to accurately detect pN+ is 60 for shorter, well-differentiated cancers (

Original languageEnglish (US)
JournalAnnals of Surgery
DOIs
StateAccepted/In press - Jan 7 2016

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ASJC Scopus subject areas

  • Surgery

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Rice, T. W., Ishwaran, H., Hofstetter, W. L., Schipper, P. H., Kesler, K. A., Law, S., Lerut, E. M. R., Denlinger, C. E., Salo, J. A., Scott, W. J., Watson, T. J., Allen, M. S., Chen, L. Q., Rusch, V. W., Cerfolio, R. J., Luketich, J. D., Duranceau, A., Darling, G. E., Pera, M., ... Blackstone, E. H. (Accepted/In press). Esophageal Cancer: Associations With (pN+) Lymph Node Metastases. Annals of Surgery. https://doi.org/10.1097/SLA.0000000000001594