The management of patients with esophageal cancer with malignant celiac lymph nodes (CLNs) is controversial.
Dr Marsman and colleagues from the Netherlands undertook a study to evaluate the management and survival of patients with positive CLN findings on endoscopic ultrasonography (EUS).
The research group compared the outcome in surgically treated patients with that of nonsurgically treated patients.
The researchers retrospectively searched the EUS database of the Academic Medical Center for patients with esophageal carcinoma and EUS-positive CLN.
The team followed-up participants by reviewing their medical charts and contacting their general practitioners.
In total, the researchers included 78 patients from 1993 through 2000 who had esophageal carcinoma and suspicious CLN.
|Median survival for the surgical group was 13.7 months vs. 13.5 months for the nonsurgical group with CLN size < 2 cm|
The researchers found that 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.
In a multivariate model, the research group noted that size was the only predictive factor for poor patient survival.
Out of the 78 study patients, the investigators allocated 13 patients to undergo a surgical resection and 65 to receive nonsurgical treatment.
The team noted that the surgical group was significantly younger and all patients in this group had CLN size < 2 cm.
The researchers found that the median survival for the surgical group was 13.7 months vs. 13.5 months for the nonsurgical group with CLN size < 2 cm.
Dr Marsman, speaking on behalf of his colleagues, concluded, "In this retrospective study, CLN size was a significant predictor for poor survival."
"The surgically treated patients had a medium-term survival similar to that of nonsurgically treated patients with a CLN size < 2 cm."
"These findings underline the prognostic value of CLN size in patients with esophageal carcinoma."