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

Number of Access:63（2025-10-21 07:45 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/102747

Link to primary information

File	Format	Terms of use	Size	Views	Date.Available	Description	information
AnnSurgOncol_2025	pdf	None	561 KB	17	2025.09.19

Creative Commons : Attribution

Item Information

Output File Export EndNote Basic Export Mendeley

Title	Outcome of Conversion Surgery After Induction Therapy for Esophageal Cancer with Synchronous Para-Aortic Lymph Node Metastasis: A Multi-institutional Retrospective Study
Creator	NRID 1000070621019 1000070621019 ORCID 0000-0001-5178-9388 0000-0001-5178-9388 researchmap permalink koji_tanaka koji_tanaka Scopus Author ID 55628548952 55628548952 CreatorName Tanaka, Koji
	CreatorName Sugimura, Keijiro
	CreatorName Matsuura, Norihiro
	NRID 1000070388536 1000070388536 CreatorName Shiraishi, Osamu
	NRID 1000050749752 1000050749752 ORCID 0009-0004-2623-2122 0009-0004-2623-2122 researchmap permalink kom2005 kom2005 CreatorName Momose, Kota
	NRID 1000020747159 1000020747159 researchmap permalink k-yamashita k-yamashita Scopus Author ID 57191498316 57191498316 CreatorName Yamashita, Kotaro
	NRID 1000010745425 1000010745425 CreatorName Sugase, Takahito
	CreatorName Kanemura, Takashi
	NRID 1000080528620 1000080528620 researchmap permalink _-_-_- _-_-_- Scopus Author ID 56339970700 56339970700 CreatorName Makino, Tomoki
	CreatorName Takeno, Atsushi
	CreatorName Kawabata, Ryohei
	CreatorName Motoori, Masaaki
	NRID 1000080716994 1000080716994 CreatorName Kimura, Yutaka
	NRID 1000050444518 1000050444518 CreatorName Yamasaki, Makoto
	CreatorName Miyata, Hiroshi
	CreatorName Fujitani, Kazumasa
	NRID 1000010324782 1000010324782 CreatorName Yasuda, Takushi
	NRID 1000070273646 1000070273646 CreatorName Yano, Masahiko
	NRID 1000090542118 1000090542118 researchmap permalink abcdabcdabcd abcdabcdabcd Scopus Author ID 7101627772 7101627772 ORCID 0000-0002-2318-1129 0000-0002-2318-1129 CreatorName Eguchi, Hidetoshi
	NRID 1000020291445 1000020291445 researchmap permalink ydoki3251 ydoki3251 Scopus Author ID 7006390687 7006390687 CreatorName Doki, Yuichiro
Subject	Conversion surgery
	Esophageal cancer
	Para-aortic lymph node
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.
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.
Publisher	Springer Science and Business Media Deutschland GmbH
Source Title	Annals of Surgical Oncology
Date of Issued	2025-08-20
Language	English
Handle URL	https://hdl.handle.net/11094/102747
PISSN	10689265
eISSN	15344681
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1245/s10434-025-18042-w
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	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	English
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	English
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

Link to primary information

Item Information

Show details