Mediastinal lymphadenectomy for esophageal cancer: Differences between two countries, Japan and the Netherlands
Extent of mediastinal lymphadenectomy during esophagectomy is clearly different between two representative countries of the Eastern and Western world, such as Japan and the Netherlands. In Japan, a clear policy is the standard complete two‐ or three‐field type of lymphadenectomy whereas, in the Neth...
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Published in | Annals of gastroenterological surgery Vol. 2; no. 3; pp. 176 - 181 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Japan
John Wiley & Sons, Inc
01.05.2018
John Wiley and Sons Inc |
Subjects | |
Online Access | Get full text |
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Summary: | Extent of mediastinal lymphadenectomy during esophagectomy is clearly different between two representative countries of the Eastern and Western world, such as Japan and the Netherlands. In Japan, a clear policy is the standard complete two‐ or three‐field type of lymphadenectomy whereas, in the Netherlands, a limited form is usually carried out. Reasons for these differences can be found in the different types of tumor, 80% of adenocarcinomas in the West and almost 95% of squamous cell cancer in Japan. Moreover, location of the tumors, distally located in the Netherlands whereas, in Japan, the majority are located in the middle and proximal thoracic esophagus. Also, type of neoadjuvant therapy, namely chemoradiotherapy in the Netherlands, and chemotherapy in Japan, are different. Arguments for more extended mediastinal lymphadenectomy are currently challenged in the West, first by the systematic use of chemoradiotherapy as neoadjuvant therapy and, second, the retrospective analysis of large data. According to two studies, the importance of extended lymphadenectomy is shown to be relative and less clear, especially in esophageal adenocarcinomas after neoadjuvant therapy. International efforts such as the TIGER study will help to standardize and find a relationship between the type and location of esophageal cancer, use of neoadjuvant therapy, extent of lymphadenectomy and survival.
This study describes important differences in the extension of mediastinal lymphadenectomy during esophagectomy between East and West. These differences are based on the type of cancer, adenocarcinoma or squamous cell cancer, its location in the thoracic esophagus and the use of different neoadjuvant therapy. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1 Presented at the Congress of the Japanese Society of Gastroenterological Surgery at Kanazawa, 21 July 2017. |
ISSN: | 2475-0328 2475-0328 |
DOI: | 10.1002/ags3.12172 |