Esophageal nodal failure -

Hello. Looking for any input on this challenging case. 58 yo male, obese. neoadj chemo (carbo/taxol)-XRT (50.4 Gy total dose as 41.4 then boost gross disease) for cT3N0 GE junction adeno completed 7/2018. Ivor Lewis Esophagectomy 10/2018 with 4mm residual disease ypT1bN2 (4 nodes + out of 18 submitted). 1 year later (11/2018) on imaging he has a high level 4R mediastinal node look slightly larger. It is above his anastomosis (at carina) and above his prior radiation. It's hot on PET... Esophageal nodal failure -
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Radiation Oncology Source Type: forums

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AbstractPurposeRelationships among body composition indices assessed by various modalities remain to be addressed in patients with esophageal squamous cell carcinoma (ESCC), in whom being underweight is more strikingly prevalent than in those with other malignancies. We investigated the relationships of body composition parameters with the sarcopenia prevalence of ESCC patients.MethodsIn this prospective study, we analyzed preoperative data obtained from 75 ESCC patients undergoing esophagectomy. Body composition data included body mass index (BMI), skeletal muscle index (SMI) assessed by computed tomography, and parameter...
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
In this study, we assessed the relationship between visceral obesity and postoperative inflammatory response following minimally invasive esophagectomy (MIE).MethodsVisceral fat area (VFA) was measured using computed tomography in 152 patients undergoing MIE for esophageal cancer. We assessed perioperative serum C-reactive protein (CRP) levels preoperatively and on postoperative days (PODs) 1 –5 and analyzed the relationship between VFA and perioperative serum CRP levels.ResultsVFA was positively associated with preoperative serum CRP level (P 
Source: World Journal of Surgery - Category: Surgery Source Type: research
Publication date: October 2018Source: The Annals of Thoracic Surgery, Volume 106, Issue 4Author(s): Brian Mitzman, Paul H. Schipper, Melanie A. Edwards, Sunghee Kim, Mark K. FergusonBackgroundBody mass index (BMI) is not routinely taken into consideration for risk stratification prior to esophagectomy. Extremes of BMI are associated with adverse surgical outcomes in a variety of surgical specialties. We assessed the relationship of BMI to outcomes after esophagectomy for cancer.MethodsPatients in the Society of Thoracic Surgeons General Thoracic Surgery Database (2009 to 2016) who underwent elective esophagectomy for cance...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
ConclusionsGastric ischemic conditioning is associated with fewer overall anastomotic complications, fewer strictures, and less morbidity. Randomized studies may determine optimal selection criteria to determine whom best benefits from ischemic conditioning.
Source: Journal of Gastrointestinal Surgery - Category: Surgery Source Type: research
Abstract BACKGROUND: Body mass index (BMI) is not routinely taken into consideration for risk stratification prior to esophagectomy. Extremes of BMI are associated with adverse surgical outcomes in a variety of surgical specialties. We assessed the relationship of BMI to outcomes after esophagectomy for cancer. METHODS: Patients in the Society of Thoracic Surgeons General Thoracic Surgery Database (2009 - 2016) who underwent elective esophagectomy for cancer were selected for analysis. Open and minimally invasive approaches were included. Complications were categorized based on the Esophagectomy Complications...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
PMID: 29287753 [PubMed - in process]
Source: Surgery for Obesity and Related Diseases : official journal of the American Society for Bariatric Surgery - Category: Surgery Authors: Tags: Surg Obes Relat Dis Source Type: research
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
Obesity is now epidemic worldwide, and an increasing number of patients have undergone a weight-loss procedure. Although obesity is a risk factor for esophageal cancer, there are few reports on esophagectomy after bariatric procedures. Careful understanding of the patient ’s gastroesophageal anatomy as a result of the bariatric procedure and attention to the creation of the esophageal replacement conduit are fundamental for the success of esophagectomy after bariatric surgery.
Source: Thoracic Surgery Clinics - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
CONCLUSIONS: Overweight patients and OE are independently associated with a significant higher incidence of post-operative respiratory infections, i.e., pneumonia. PMID: 28815084 [PubMed]
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
Aims: To investigate the prognostic significance of body mass index (BMI) on the survival of patients with esophageal squamous cell carcinoma (ESCC) after esophagectomy.Methods: Between 2005 and 2008, 291 patients with ESCC who met the inclusion criteria were included in the study. The BMI cut-off values were as follows: 18.5-23 kg/m2 for normal weight; 23-27.5 kg/m2 for overweight; and ≥27.5 kg/m2 for those with obesity. Univariate and multivariate analyses were performed to identify prognostic factors for long-term survival.Results: Patients were divided into 3 groups: normal weight (n = 138), overweight (n = 103), an...
Source: Digestive Surgery - Category: Surgery Source Type: research
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