"Additionally, the lymph node ratio (the ratio of the number of positive lymph nodes to the number of dissected lymph nodes) has been shown to be the strongest predictor of death in patients with gastric cancer and esophageal carcinoma [13, 14]. Furthermore, the pathologic assessment of a minimum of 12 lymph nodes has been reported to provide sufficient prognostic information . "
[Show abstract][Hide abstract] ABSTRACT: This retrospective study investigated the effect of modifications presented in the seventh edition of the American Joint Committee on Cancer (AJCC) Manual for staging esophageal cancer on the characterization of the effectiveness of post-operative chemotherapy and/or radiotherapy, as measured by overall and disease-free survival. The seventh edition of the AJCC Manual classifies the number of lymph nodes (N) positive for regional metastasis into three subclasses. We used the AJCC classification system to characterize the cancers of 413 Chinese patients with esophageal cancer who underwent radical resection plus regional lymph node dissection over a 10-year period. The 10-year survival rate was 14.3% for stage N1 patients and 6.1% for stage N2 patients. Only one stage N3 patient was followed >4 years (53.4 months). The 10-year disease-free rate was 13.6% for stage N1 patients. Patients with stage N2 or N3 cancer were more likely to have tumor recurrences, metastases or death than patients with stage N1 cancer. Post-operative radiotherapy provided no survival benefit, and may have had a negative effect on survival. In this study, the N stage of esophageal cancer was an independent factor affecting overall and disease-free survival. Our results did not clarify whether or not radiotherapy after radical esophagectomy offers any survival benefit to patients with esophageal cancer.
Journal of Radiation Research 11/2012; 54(2). DOI:10.1093/jrr/rrs096 · 1.80 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: An algorithm is described which operates on a digitized television frame or digital infrared image to rapidly locate tightly clustered objects which occupy less than half the field of view and which can be enclosed by rectangles. The algorithm uses a maximum entropy image and projections in place of arbitrary heuristics to guide the location and segmentation process.
Acoustics, Speech, and Signal Processing, IEEE International Conference on ICASSP '84.; 04/1984
[Show abstract][Hide abstract] ABSTRACT: Patients with esophageal carcinoma who appear to have a complete response at the primary tumor site after undergoing neoadjuvant chemoradiotherapy may still have residual disease in regional lymph nodes despite clinically negative restaging (ypT0N1). We hypothesized that these patients would have similar survival to patients with incomplete response to therapy.
We reviewed 336 esophageal cancer patients who received neoadjuvant chemoradiotherapy followed by complete resection. We identified 20 patients who obtained complete pathologic response at the primary tumor with persistent metastatic disease to regional lymph nodes (ypT0N1). These patients were compared to 123 patients with pathologic complete response and 193 with partial response for overall survival.
Demographics among the three groups of patients were similar except that this cohort of patients with ypT0N1 had higher initial clinical stage (p = 0.013) and had more squamous cell carcinoma pathology (p = 0.005). Eighty-six percent of the ypT0N1 patients who had modern preoperative staging were felt to have clinical complete response. Five-year survival of ypT0N1 patients was intermediate, similar to pathologic partial response stage II patients in both the sixth and seventh editions of the American Joint Committee on Cancer staging criteria.
Clinical staging of complete response to chemoradiotherapy may not translate to pathologic complete response. Patients with ypT0N1 disease at resection have intermediate but reasonable survival, justifying an aggressive approach to curative therapy. Future revisions of the staging system should place this group of patients with patients who have metastatic regional lymph nodes, stratified by number of nodes involved.
The Annals of thoracic surgery 09/2010; 90(3):884-90; discussion 890-1. DOI:10.1016/j.athoracsur.2010.03.116 · 3.85 Impact Factor
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