Esophageal Cancer: Associations With (pN+) Lymph Node Metastases

Thomas W. Rice, Hemant Ishwaran, Wayne L. Hofstetter, Paul Schipper, Kenneth A. Kesler, Simon Law, E. M R Lerut, Chadrick E. Denlinger, Jarmo A. Salo, Walter J. Scott, Thomas J. Watson, Mark S. Allen, Long Qi Chen, Valerie W. Rusch, Robert J. Cerfolio, James D. Luketich, Andre Duranceau, Gail E. Darling, Manuel Pera, Carolyn Apperson-HansenEugene H. Blackstone

    Research output: Contribution to journalArticle

    31 Citations (Scopus)

    Abstract

    OBJECTIVES:: To identify the associations of lymph node metastases (pN+), number of positive nodes, and pN subclassification with cancer, treatment, patient, geographic, and institutional variables, and to recommend extent of lymphadenectomy needed to accurately detect pN+ for esophageal cancer. SUMMARY BACKGROUND DATA:: Limited data and traditional analytic techniques have precluded identifying intricate associations of pN+ with other cancer, treatment, and patient characteristics. METHODS:: Data on 5806 esophagectomy patients from the Worldwide Esophageal Cancer Collaboration were analyzed by Random Forest machine learning techniques. RESULTS:: pN+, number of positive nodes, and pN subclassification were associated with increasing depth of cancer invasion (pT), increasing cancer length, decreasing cancer differentiation (G), and more regional lymph nodes resected. Lymphadenectomy necessary to accurately detect pN+ is 60 for shorter, well-differentiated cancers (

    Original languageEnglish (US)
    JournalAnnals of Surgery
    DOIs
    StateAccepted/In press - Jan 7 2016

    Fingerprint

    Esophageal Neoplasms
    Lymph Nodes
    Neoplasm Metastasis
    Neoplasms
    Lymph Node Excision
    Esophagectomy
    Therapeutics

    ASJC Scopus subject areas

    • Surgery

    Cite this

    Rice, T. W., Ishwaran, H., Hofstetter, W. L., Schipper, P., Kesler, K. A., Law, S., ... Blackstone, E. H. (Accepted/In press). Esophageal Cancer: Associations With (pN+) Lymph Node Metastases. Annals of Surgery. https://doi.org/10.1097/SLA.0000000000001594

    Esophageal Cancer : Associations With (pN+) Lymph Node Metastases. / Rice, Thomas W.; Ishwaran, Hemant; Hofstetter, Wayne L.; Schipper, Paul; Kesler, Kenneth A.; Law, Simon; Lerut, E. M R; Denlinger, Chadrick E.; Salo, Jarmo A.; Scott, Walter J.; Watson, Thomas J.; Allen, Mark S.; Chen, Long Qi; Rusch, Valerie W.; Cerfolio, Robert J.; Luketich, James D.; Duranceau, Andre; Darling, Gail E.; Pera, Manuel; Apperson-Hansen, Carolyn; Blackstone, Eugene H.

    In: Annals of Surgery, 07.01.2016.

    Research output: Contribution to journalArticle

    Rice, TW, Ishwaran, H, Hofstetter, WL, Schipper, P, Kesler, KA, Law, S, Lerut, EMR, Denlinger, CE, Salo, JA, Scott, WJ, Watson, TJ, Allen, MS, Chen, LQ, Rusch, VW, Cerfolio, RJ, Luketich, JD, Duranceau, A, Darling, GE, Pera, M, Apperson-Hansen, C & Blackstone, EH 2016, 'Esophageal Cancer: Associations With (pN+) Lymph Node Metastases', Annals of Surgery. https://doi.org/10.1097/SLA.0000000000001594
    Rice, Thomas W. ; Ishwaran, Hemant ; Hofstetter, Wayne L. ; Schipper, Paul ; Kesler, Kenneth A. ; Law, Simon ; Lerut, E. M R ; Denlinger, Chadrick E. ; Salo, Jarmo A. ; Scott, Walter J. ; Watson, Thomas J. ; Allen, Mark S. ; Chen, Long Qi ; Rusch, Valerie W. ; Cerfolio, Robert J. ; Luketich, James D. ; Duranceau, Andre ; Darling, Gail E. ; Pera, Manuel ; Apperson-Hansen, Carolyn ; Blackstone, Eugene H. / Esophageal Cancer : Associations With (pN+) Lymph Node Metastases. In: Annals of Surgery. 2016.
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    abstract = "OBJECTIVES:: To identify the associations of lymph node metastases (pN+), number of positive nodes, and pN subclassification with cancer, treatment, patient, geographic, and institutional variables, and to recommend extent of lymphadenectomy needed to accurately detect pN+ for esophageal cancer. SUMMARY BACKGROUND DATA:: Limited data and traditional analytic techniques have precluded identifying intricate associations of pN+ with other cancer, treatment, and patient characteristics. METHODS:: Data on 5806 esophagectomy patients from the Worldwide Esophageal Cancer Collaboration were analyzed by Random Forest machine learning techniques. RESULTS:: pN+, number of positive nodes, and pN subclassification were associated with increasing depth of cancer invasion (pT), increasing cancer length, decreasing cancer differentiation (G), and more regional lymph nodes resected. Lymphadenectomy necessary to accurately detect pN+ is 60 for shorter, well-differentiated cancers (",
    author = "Rice, {Thomas W.} and Hemant Ishwaran and Hofstetter, {Wayne L.} and Paul Schipper and Kesler, {Kenneth A.} and Simon Law and Lerut, {E. M R} and Denlinger, {Chadrick E.} and Salo, {Jarmo A.} and Scott, {Walter J.} and Watson, {Thomas J.} and Allen, {Mark S.} and Chen, {Long Qi} and Rusch, {Valerie W.} and Cerfolio, {Robert J.} and Luketich, {James D.} and Andre Duranceau and Darling, {Gail E.} and Manuel Pera and Carolyn Apperson-Hansen and Blackstone, {Eugene H.}",
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    TY - JOUR

    T1 - Esophageal Cancer

    T2 - Associations With (pN+) Lymph Node Metastases

    AU - Rice, Thomas W.

    AU - Ishwaran, Hemant

    AU - Hofstetter, Wayne L.

    AU - Schipper, Paul

    AU - Kesler, Kenneth A.

    AU - Law, Simon

    AU - Lerut, E. M R

    AU - Denlinger, Chadrick E.

    AU - Salo, Jarmo A.

    AU - Scott, Walter J.

    AU - Watson, Thomas J.

    AU - Allen, Mark S.

    AU - Chen, Long Qi

    AU - Rusch, Valerie W.

    AU - Cerfolio, Robert J.

    AU - Luketich, James D.

    AU - Duranceau, Andre

    AU - Darling, Gail E.

    AU - Pera, Manuel

    AU - Apperson-Hansen, Carolyn

    AU - Blackstone, Eugene H.

    PY - 2016/1/7

    Y1 - 2016/1/7

    N2 - OBJECTIVES:: To identify the associations of lymph node metastases (pN+), number of positive nodes, and pN subclassification with cancer, treatment, patient, geographic, and institutional variables, and to recommend extent of lymphadenectomy needed to accurately detect pN+ for esophageal cancer. SUMMARY BACKGROUND DATA:: Limited data and traditional analytic techniques have precluded identifying intricate associations of pN+ with other cancer, treatment, and patient characteristics. METHODS:: Data on 5806 esophagectomy patients from the Worldwide Esophageal Cancer Collaboration were analyzed by Random Forest machine learning techniques. RESULTS:: pN+, number of positive nodes, and pN subclassification were associated with increasing depth of cancer invasion (pT), increasing cancer length, decreasing cancer differentiation (G), and more regional lymph nodes resected. Lymphadenectomy necessary to accurately detect pN+ is 60 for shorter, well-differentiated cancers (

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