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    Distribution of lymph node metastases in esophageal carcinoma [TIGER study]: study protocol of a multinational observational study.

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    Authors
    Hagens, Eliza R C
    van Berge Henegouwen, Mark I
    van Sandick, Johanna W
    Cuesta, Miguel A
    van der Peet, Donald L
    Heisterkamp, Joos
    Nieuwenhuijzen, Grard A P
    Rosman, Camiel
    Scheepers, Joris J G
    Sosef, Meindert N
    van Hillegersberg, Richard
    Lagarde, Sjoerd M
    Nilsson, Magnus
    Räsänen, Jari
    Nafteux, Philippe
    Pattyn, Piet
    Hölscher, Arnulf H
    Schröder, Wolfgang
    Schneider, Paul M
    Mariette, Christophe
    Castoro, Carlo
    Bonavina, Luigi
    Rosati, Riccardo
    de Manzoni, Giovanni
    Mattioli, Sandro
    Garcia, Josep Roig
    Pera, Manuel
    Griffin, Michael
    Wilkerson, Paul
    Chaudry, M Asif
    Sgromo, Bruno
    Tucker, Olga
    Cheong, Edward
    Moorthy, Krishna
    Walsh, Thomas N
    Reynolds, John
    Tachimori, Yuji
    Inoue, Haruhiro
    Matsubara, Hisahiro
    Kosugi, Shin-Ichi
    Chen, Haiquan
    Law, Simon Y K
    Pramesh, C S
    Puntambekar, Shailesh P
    Murthy, Sudish
    Linden, Philip
    Hofstetter, Wayne L
    Kuppusamy, Madhan K
    Shen, K Robert
    Darling, Gail E
    Sabino, Flávio D
    Grimminger, Peter P
    Meijer, Sybren L
    Bergman, Jacques J G H M
    Hulshof, Maarten C C M
    van Laarhoven, Hanneke W M
    Mearadji, Banafsche
    Bennink, Roel J
    Annema, Jouke T
    Dijkgraaf, Marcel G W
    Gisbertz, Suzanne S
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    Issue Date
    2019-07-04
    Keywords
    Esophageal cancer
    Esophagectomy
    Lymph node metastases
    Lymphadenectomy
    
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    Show full item record
    Journal
    BMC cancer
    URI
    http://hdl.handle.net/10147/627233
    DOI
    10.1186/s12885-019-5761-7
    PubMed ID
    31272485
    Abstract
    Background: An important parameter for survival in patients with esophageal carcinoma is lymph node status. The distribution of lymph node metastases depends on tumor characteristics such as tumor location, histology, invasion depth, and on neoadjuvant treatment. The exact distribution is unknown. Neoadjuvant treatment and surgical strategy depends on the distribution pattern of nodal metastases but consensus on the extent of lymphadenectomy has not been reached. The aim of this study is to determine the distribution of lymph node metastases in patients with resectable esophageal or gastro-esophageal junction carcinoma in whom a transthoracic esophagectomy with a 2- or 3-field lymphadenectomy is performed. This can be the foundation for a uniform worldwide staging system and establishment of the optimal surgical strategy for esophageal cancer patients. Methods: The TIGER study is an international observational cohort study with 50 participating centers. Patients with a resectable esophageal or gastro-esophageal junction carcinoma in whom a transthoracic esophagectomy with a 2- or 3-field lymphadenectomy is performed in participating centers will be included. All lymph node stations will be excised and separately individually analyzed by pathological examination. The aim is to include 5000 patients. The primary endpoint is the distribution of lymph node metastases in esophageal and esophago-gastric junction carcinoma specimens following transthoracic esophagectomy with at least 2-field lymphadenectomy in relation to tumor histology, tumor location, invasion depth, number of lymph nodes and lymph node metastases, pre-operative diagnostics, neo-adjuvant therapy and (disease free) survival. Discussion: The TIGER study will provide a roadmap of the location of lymph node metastases in relation to tumor histology, tumor location, invasion depth, number of lymph nodes and lymph node metastases, pre-operative diagnostics, neo-adjuvant therapy and survival. Patient-tailored treatment can be developed based on these results, such as the optimal radiation field and extent of lymphadenectomy based on the primary tumor characteristics.
    Item Type
    Article
    Language
    en
    EISSN
    1471-2407
    ae974a485f413a2113503eed53cd6c53
    10.1186/s12885-019-5761-7
    Scopus Count
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    Connolly Hospital

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