Pathological analysis of clinical target volume margin for radiotherapy in patients with esophageal and gastroesophageal junction carcinoma

Xian shu Gao, Xueying Qiao, Fengpeng Wu, Li Cao, Xianli Meng, Zhiming Dong, Xiaoling Wang, Guodong Gao, Tsung Teh Wu, Ritsuko Komaki, Joe Y. Chang

Research output: Contribution to journalArticle

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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 languageEnglish (US)
Pages (from-to)389-396
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume67
Issue number2
DOIs
StatePublished - Feb 1 2007
Externally publishedYes

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Esophagogastric Junction
radiation therapy
margins
Radiotherapy
cancer
Adenocarcinoma
Carcinoma
esophagus
lymphatic system
metastasis
Esophagus
tumors
Lymph Nodes
Neoplasm Metastasis
Neoplasms
Intercellular Junctions
Esophageal Neoplasms
Squamous Cell Carcinoma
Esophageal Squamous Cell Carcinoma

Keywords

  • Adenocarcinoma of gastroesophageal junction
  • Clinical target volume
  • Esophageal carcinoma
  • Esophagectomy
  • Lymph node metastasis
  • Microscopic spread

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Pathological analysis of clinical target volume margin for radiotherapy in patients with esophageal and gastroesophageal junction carcinoma. / Gao, Xian shu; Qiao, Xueying; Wu, Fengpeng; Cao, Li; Meng, Xianli; Dong, Zhiming; Wang, Xiaoling; Gao, Guodong; Wu, Tsung Teh; Komaki, Ritsuko; Chang, Joe Y.

In: International Journal of Radiation Oncology Biology Physics, Vol. 67, No. 2, 01.02.2007, p. 389-396.

Research output: Contribution to journalArticle

Gao, Xian shu ; Qiao, Xueying ; Wu, Fengpeng ; Cao, Li ; Meng, Xianli ; Dong, Zhiming ; Wang, Xiaoling ; Gao, Guodong ; Wu, Tsung Teh ; Komaki, Ritsuko ; Chang, Joe Y. / Pathological analysis of clinical target volume margin for radiotherapy in patients with esophageal and gastroesophageal junction carcinoma. In: International Journal of Radiation Oncology Biology Physics. 2007 ; Vol. 67, No. 2. pp. 389-396.
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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.",
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AU - Gao, Xian shu

AU - Qiao, Xueying

AU - Wu, Fengpeng

AU - Cao, Li

AU - Meng, Xianli

AU - Dong, Zhiming

AU - Wang, Xiaoling

AU - Gao, Guodong

AU - Wu, Tsung Teh

AU - Komaki, Ritsuko

AU - Chang, Joe Y.

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N2 - 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.

AB - 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.

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