Outcome of Conversion Surgery After Induction Therapy for Esophageal Cancer with Synchronous Para-Aortic Lymph Node Metastasis: A Multi-institutional Retrospective Study

Tanaka, Koji; Sugimura, Keijiro; Matsuura, Norihiro; Shiraishi, Osamu; Momose, Kota; Yamashita, Kotaro; Sugase, Takahito; Kanemura, Takashi; Makino, Tomoki; Takeno, Atsushi; Kawabata, Ryohei; Motoori, Masaaki; Kimura, Yutaka; Yamasaki, Makoto; Miyata, Hiroshi; Fujitani, Kazumasa; Yasuda, Takushi; Yano, Masahiko; Eguchi, Hidetoshi; Doki, Yuichiro

doi:https://doi.org/10.1245/s10434-025-18042-w

Outcome of Conversion Surgery After Induction Therapy for Esophageal Cancer with Synchronous Para-Aortic Lymph Node Metastasis: A Multi-institutional Retrospective Study

Tanaka, Koji; Sugimura, Keijiro; Matsuura, Norihiro et al.

Annals of Surgical Oncology, 2025

アクセス数:67件（2025-10-23 15:49 集計）

固定URL: https://hdl.handle.net/11094/102747

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タイトル	Outcome of Conversion Surgery After Induction Therapy for Esophageal Cancer with Synchronous Para-Aortic Lymph Node Metastasis: A Multi-institutional Retrospective Study
著者	NRID 1000070621019 1000070621019 ORCID 0000-0001-5178-9388 0000-0001-5178-9388 researchmap permalink koji_tanaka koji_tanaka Scopus Author ID 55628548952 55628548952 著者名 Tanaka, Koji
	著者名 Sugimura, Keijiro
	著者名 Matsuura, Norihiro
	NRID 1000070388536 1000070388536 著者名 Shiraishi, Osamu
	NRID 1000050749752 1000050749752 ORCID 0009-0004-2623-2122 0009-0004-2623-2122 researchmap permalink kom2005 kom2005 著者名 Momose, Kota
	NRID 1000020747159 1000020747159 researchmap permalink k-yamashita k-yamashita Scopus Author ID 57191498316 57191498316 著者名 Yamashita, Kotaro
	NRID 1000010745425 1000010745425 著者名 Sugase, Takahito
	著者名 Kanemura, Takashi
	NRID 1000080528620 1000080528620 researchmap permalink _-_-_- _-_-_- Scopus Author ID 56339970700 56339970700 著者名 Makino, Tomoki
	著者名 Takeno, Atsushi
	著者名 Kawabata, Ryohei
	著者名 Motoori, Masaaki
	NRID 1000080716994 1000080716994 著者名 Kimura, Yutaka
	NRID 1000050444518 1000050444518 著者名 Yamasaki, Makoto
	著者名 Miyata, Hiroshi
	著者名 Fujitani, Kazumasa
	NRID 1000010324782 1000010324782 著者名 Yasuda, Takushi
	NRID 1000070273646 1000070273646 著者名 Yano, Masahiko
	NRID 1000090542118 1000090542118 researchmap permalink abcdabcdabcd abcdabcdabcd Scopus Author ID 7101627772 7101627772 ORCID 0000-0002-2318-1129 0000-0002-2318-1129 著者名 Eguchi, Hidetoshi
	NRID 1000020291445 1000020291445 researchmap permalink ydoki3251 ydoki3251 Scopus Author ID 7006390687 7006390687 著者名 Doki, Yuichiro
キーワード等	Conversion surgery
	Esophageal cancer
	Para-aortic lymph node
内容	The version of record of this article, first published in Annals of Surgical Oncology (2025), is available online at Publisher’s website: https://doi.org/10.1245/s10434-025-18042-w.
抄録	Background: Systemic chemotherapy is the standard treatment for esophageal cancer with synchronous distant metastasis including para-aortic lymph node (PALN) metastasis. The significance of conversion surgery for esophageal cancer with synchronous PALN metastasis remains controversial. Objective: The current study aimed to investigate the clinical outcome of conversion surgery for esophageal cancer with synchronous PALN metastasis after induction therapy. Methods: This multi-institutional retrospective study included 48 patients with esophageal cancer who exhibited synchronous PALN metastasis and who received induction chemotherapy or chemoradiotherapy followed by conversion surgery between 2005 and 2022. The short- and long-term treatment outcomes were examined. Results: Among the 48 patients, 45 and 3 received chemotherapy and chemoradiotherapy, respectively, as the initial treatment. Moreover, all patients underwent subtotal esophagectomy. The incidence rate of postoperative complications was 48% and the in-hospital mortality rate was 2%. The 3- and 5-year overall survival rates of all patients were 36.1% and 25.2%, respectively. The overall survival rates of patients with pN2-3 and final PALN status (fM1) were significantly lower than that of patients with pN0-1 (p = 0.0025) and fM0 (p = 0.0043). The multivariate analysis showed that pathological nodal status (hazard ratio 2.44, p = 0.0488) and fM status (hazard ratio 2.53, p = 0.0246) were independent prognostic factors. Conclusions: Conversion surgery for esophageal cancer with synchronous PALN metastasis is feasible and promising. In addition, conversion surgery for patients with controlled nodal status including PALN metastasis is important for long-term prognosis.
出版者	Springer Science and Business Media Deutschland GmbH
収録物名	Annals of Surgical Oncology
刊行年月	2025-08-20
言語	英語
ハンドルURL	https://hdl.handle.net/11094/102747
PISSN	10689265
eISSN	15344681
関連情報 (isIdenticalTo)	DOI (出版社版) https://doi.org/10.1245/s10434-025-18042-w
アクセス権	open access
権利情報	This article is licensed under a Creative Commons Attribution 4.0 International License.
出版タイプ	Version of Record
カテゴリ	学術雑誌論文 Journal Article

資源タイプ	学術雑誌論文
ローカル資源タイプ	学術雑誌論文
DCMI資源タイプ	text
DCTERMS.bibliographicCitation	Annals of Surgical Oncology. 2025
DC.title	Outcome of Conversion Surgery After Induction Therapy for Esophageal Cancer with Synchronous Para-Aortic Lymph Node Metastasis: A Multi-institutional Retrospective Study
DC.creator	Tanaka, Koji
	Sugimura, Keijiro
	Matsuura, Norihiro
	Shiraishi, Osamu
	Momose, Kota
	Yamashita, Kotaro
	Sugase, Takahito
	Kanemura, Takashi
	Makino, Tomoki
	Takeno, Atsushi
	Kawabata, Ryohei
	Motoori, Masaaki
	Kimura, Yutaka
	Yamasaki, Makoto
	Miyata, Hiroshi
	Fujitani, Kazumasa
	Yasuda, Takushi
	Yano, Masahiko
	Eguchi, Hidetoshi
	Doki, Yuichiro
DC.publisher	Springer Science and Business Media Deutschland GmbH
DC.language' scheme='DCTERMS.RFC1766	英語
DC.type' scheme='DCTERMS.DCMIType	text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2025-08-20
DC.identifier	https://doi.org/10.1245/s10434-025-18042-w
DC.subject	Conversion surgery
	Esophageal cancer
	Para-aortic lymph node
DC.description	The version of record of this article, first published in Annals of Surgical Oncology (2025), is available online at Publisher’s website: https://doi.org/10.1245/s10434-025-18042-w.
DCTERMS.abstract	Background: Systemic chemotherapy is the standard treatment for esophageal cancer with synchronous distant metastasis including para-aortic lymph node (PALN) metastasis. The significance of conversion surgery for esophageal cancer with synchronous PALN metastasis remains controversial. Objective: The current study aimed to investigate the clinical outcome of conversion surgery for esophageal cancer with synchronous PALN metastasis after induction therapy. Methods: This multi-institutional retrospective study included 48 patients with esophageal cancer who exhibited synchronous PALN metastasis and who received induction chemotherapy or chemoradiotherapy followed by conversion surgery between 2005 and 2022. The short- and long-term treatment outcomes were examined. Results: Among the 48 patients, 45 and 3 received chemotherapy and chemoradiotherapy, respectively, as the initial treatment. Moreover, all patients underwent subtotal esophagectomy. The incidence rate of postoperative complications was 48% and the in-hospital mortality rate was 2%. The 3- and 5-year overall survival rates of all patients were 36.1% and 25.2%, respectively. The overall survival rates of patients with pN2-3 and final PALN status (fM1) were significantly lower than that of patients with pN0-1 (p = 0.0025) and fM0 (p = 0.0043). The multivariate analysis showed that pathological nodal status (hazard ratio 2.44, p = 0.0488) and fM status (hazard ratio 2.53, p = 0.0246) were independent prognostic factors. Conclusions: Conversion surgery for esophageal cancer with synchronous PALN metastasis is feasible and promising. In addition, conversion surgery for patients with controlled nodal status including PALN metastasis is important for long-term prognosis.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	102747
citation_title	Outcome of Conversion Surgery After Induction Therapy for Esophageal Cancer with Synchronous Para-Aortic Lymph Node Metastasis: A Multi-institutional Retrospective Study
citation_author	Tanaka, Koji
	Sugimura, Keijiro
	Matsuura, Norihiro
	Shiraishi, Osamu
	Momose, Kota
	Yamashita, Kotaro
	Sugase, Takahito
	Kanemura, Takashi
	Makino, Tomoki
	Takeno, Atsushi
	Kawabata, Ryohei
	Motoori, Masaaki
	Kimura, Yutaka
	Yamasaki, Makoto
	Miyata, Hiroshi
	Fujitani, Kazumasa
	Yasuda, Takushi
	Yano, Masahiko
	Eguchi, Hidetoshi
	Doki, Yuichiro
citation_publisher	Springer Science and Business Media Deutschland GmbH
citation_language	英語
citation_date	2025-08-20
citation_journal_title	Annals of Surgical Oncology
citation_doi	https://doi.org/10.1245/s10434-025-18042-w
citation_public_url	https://hdl.handle.net/11094/102747

Outcome of Conversion Surgery After Induction Therapy for Esophageal Cancer with Synchronous Para-Aortic Lymph Node Metastasis: A Multi-institutional Retrospective Study

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