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Background: Oesophageal squamous cell carcinoma is one of the most commonly diagnosed carcinomas in China, and postoperative radiotherapy plays an important role in improving the prognosis of patients. Carcinomas in different locations of the oesophagus could have different patterns of lymph node metastasis after surgery., Methods: In this multicentric retrospective study, we enrolled patients with middle thoracic oesophageal squamous cell carcinomas from 3 cancer centres, and none of the patients underwent radiotherapy before or after surgery. We analysed the lymph node recurrence rates in different stations to explore the postoperative lymphatic recurrence pattern., Results: From January 1st, 2014, to December 31st, 2019, 132 patients met the criteria, and were included in this study. The lymphatic recurrence rate was 62.1%. Pathological stage (P = 0.032) and lymphadenectomy method (P = 0.006) were significant predictive factors of lymph node recurrence. The recurrence rates in the supraclavicular, upper and lower paratracheal stations of lymph nodes were 32.6%, 28.8% and 16.7%, respectively, showing a high incidence. The recurrence rate of the subcarinal node station was 9.8%, while 8.3% (upper, middle and lower) thoracic para-oesophageal nodes had recurrences., Conclusions: We recommend including the supraclavicular, upper and lower paratracheal stations of lymph nodes in the postoperative radiation field in middle thoracic oesophageal carcinomas. Subcarinal station is also potentially high-risk, while whether to include thoracic para-oesophageal or abdominal nodes needs careful consideration., (© 2024. The Author(s).)

Background: To study lymphatic recurrence distribution after radical surgery in the real world and guide clinical tumor volume delineation for regional lymph nodes during postoperative radiotherapy for lower thoracic squamous cell esophageal carcinomas., Methods: We enrolled patients who underwent radical esophagectomy, without radiation before or after surgery, at 3 cancer hospitals. Patients were classified into groups according to tumor locations. We included patients with tumors in the lower thoracic segment and analyzed the postoperative lymph node recurrence mode. A cutoff value of 10% was used to differentiate high-risk lymph node drainage areas from others., Results: We enrolled 1905 patients in the whole study series, including 652 thoracic esophageal carcinomas that met our inclusion criteria; there were 241 cases of lower thoracic esophageal carcinomas. 1st, 2nd, 4th, 7th, 8th groups of lymph nodes, according to the 8th edition of the AJCC classification, displayed as high-risk recurrence areas, representing 17.8%, 23.9%, 11.7%, 10.9% and 12.2% of lymph node recurrence. Stage III-IV tumors located in the lower segment of the thoracic esophagus showed a tendency to recur in the left gastric nodes (7.9%) and celiac nodes (10.6%)., Conclusions: According to our results, we recommended including the 4th, 7th and 8th groups of lymph nodes in the radiation field, and for patients with stage III-IV disease, the 17th and 20th groups of nodes should be irradiated during postoperative treatment. Whether including 1st/2nd groups in preventive irradiation needed more proofs., (© 2022. The Author(s).)

Introduction: Whether supraclavicular lymph node (SCLN) metastasis in patients with oesophageal cancer belongs to regional disease is controversial, leading to heterogeneity in clinical treatment decisions. This study aimed to determine the optimal treatment for lower thoracic oesophageal cancer (LTOC) with SCLN metastasis. Methods: Patients with LTOC registered in the Surveillance, Epidemiology, and End Results database during 2010–2015 were identified. Selected patients were grouped according to disease spread as those with locoregional disease, with SCLN metastasis or with distant metastasis, as well as according to treatment modality (neoadjuvant chemoradiotherapy followed by surgery (nCRT+S group), upfront surgery ± adjuvant therapy (upfront S group) and definitive chemoradiotherapy (dCRT group)). The Cox regression analysis and inverse probability of treatment weighting (IPTW) were used to identify the optimal treatment modality for different groups. Results: Of 11,767 LTOC patients identified from the database, the 5‐year overall survival (OS) rates for patients with the locoregional disease (n = 7,541), SCLN metastasis (n = 120) and distant metastasis (n = 4,106) were 28.3%, 10.0% and 3.0%, respectively (P < 0.001). Among patients with SCLN metastasis, median OS in the nCRT+S, upfront S and dCRT groups were 25, 14 and 8 months, respectively (P < 0.001). After IPTW, the nCRT+S group was still associated with better median OS compared with other groups. The multivariate analysis identified treatment modality as an independent prognostic factor for OS. Conclusions: Neoadjuvant chemoradiotherapy followed by oesophagectomy may be the optimal treatment modality for LTOC with SCLN metastasis. The findings of this study need to be validated in large prospective studies. [ABSTRACT FROM AUTHOR]

To explore the value of modified intraoperative real-time 125I seed implantation planning for lumbar lymph nodes metastases. We collected 26 lymph nodes metastases patients, who received 125I seed implantation from January 2015 to December 2021. 13 patients procedure were guided by modified intraoperative real-time treatment plan, and the rest were guided by conventional treatment plan. To compare the differences of the dosimetric parameters between pre-plan and post-plan of the 2 groups, and the percentage difference of the dosimetric parameters between the 2 groups. Then evaluate the curative effect and side effects after 6-month. There were no significant differences in dosimetric parameters between pre-plan and post-plan in modified intraoperative real-time treatment plan group, and showed significant differences in V 150 between pre-plan and post-plan in conventional treatment plan group(z =-3.045, P <0.001), and the rest dosimetric parameters of conventional treatment plan group showed no significant differences beforeand after operation(P >0.05). The percentage difference of V 150 between the 2 groups showed statistically significant(z =2.103 , P =0.004), and the rest dosimetric parameters showed no significant differences(P >0.05).6 months after the brachytherapy, the effective rate of Modified intraoperative real-time treatment plan group was 77%(10/13), and 46%(6/13) in Conventional treatment plan group, and no peritonitis and hemorrhage were observed. The application of modified real-time planning improved accuracy of dosimetric, reduced the high dose rate area, and provide guarantee for 125I seed implantation planning for lumbar lymph nodes metastases. [ABSTRACT FROM AUTHOR]