Abstract
Purpose: To clarify the radiotherapy clinical target volume (CTV) margin needed for esophageal squamous-cell carcinoma (SCC) and gastroesophageal junction (GEJ) adenocarcinoma. Methods and Materials: Surgical specimens of esophageal SCC (n = 34) and GEJ adenocarcinoma (n = 32) were prospectively collected and analyzed for microscopic spread along the esophagus and GEJ both proximally and distally from gross tumor and for lymph node (LN) metastasis. Results: For SCC, the mean microscopic spread beyond the gross tumor was 10.5 ± 13.5 mm proximally (<30 mm in 32 of 34 cases) and 10.6 ± 8.1 mm distally (<30 mm in 33 of 34 cases). For GEJ adenocarcinoma, the spread was 10.3 ± 7.2 mm proximally (<30 mm in 29 of 29 cases) and 18.3 ± 16.3 mm distally (<30 mm in 27 of 32 cases). The extent of microscopic spread of cancer was significantly associated with pathologic T stage (p = 0.012). LN metastases were observed in 12 (35%) of 34 patients with middle and lower esophageal SCC and 15 (47%) of 32 patients with GEJ adenocarcinoma. Conclusions: The extent of microscopic spread within esophagus (recommended CTV margin) was <30 mm in about 94% of cases of esophageal cancer, except for distal microscopic spread in GEJ adenocarcinoma, in which 50 mm was needed to cover about 94% of cases.
Original language | English (US) |
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Pages (from-to) | 389-396 |
Number of pages | 8 |
Journal | International Journal of Radiation Oncology Biology Physics |
Volume | 67 |
Issue number | 2 |
DOIs | |
State | Published - Feb 1 2007 |
Keywords
- Adenocarcinoma of gastroesophageal junction
- Clinical target volume
- Esophageal carcinoma
- Esophagectomy
- Lymph node metastasis
- Microscopic spread
ASJC Scopus subject areas
- Radiation
- Oncology
- Radiology Nuclear Medicine and imaging
- Cancer Research