Lymphatic Micrometastases in Patients With Early Esophageal Adenocarcinoma

Brechtje Grotenhuis, Marilene Heijl, Bas Wijnhoven, MIV Henegouwen, Katharina Biermann, FJW ten Kate, ORC Busch, Winand Dinjens, Hugo Tilanus, Jan van Lanschot

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Scopus)


Background: Both endoscopic and surgical treatments are recommended for m3- or sm1-adenocarcinomas of the esophagus, depending on patients' lymph nodal status. Lymphatic dissemination is related to tumor infiltration depth, but varying incidences have been reported in m3- and sm1-adenocarcinomas. The study aim was to investigate whether the presence of occult tumor cells in lymph nodes could explain this variation. Methods: Sixty-three node-negative (NO) patients with early esophageal adenocarcinoma (m2/m3/sm1-tumors) were included. Multilevel-sectioning of lymph nodes was performed; sections were stained by means of immunohistochemistry with cytokeratin marker CAM5.2. Two pathologists searched for micrometastases (0.2-2.0 mm) and isolated tumor cells (ITCs, <0.2 mm). Results: Positive CAM5.2 staining in lymph nodes was not seen in any of the 18 m2-patients. In 2/25m3-tumors (8.0%) an ITC was found, but no micrometastases. Tumor cells were identified in 4/20 sm1-tumors (20.0%): three micrometastases and one ITC. Median follow-up was 121 months. Two m3-patients (3.2%) died due to disease recurrence, including one patient in whom an ITC was detected. Conclusions: Lymphatic migration of tumor cells was found in node-negative m3- and sm1-adenocarcinomas of the esophagus (8.0% and 20.0%, respectively). However, the clinical relevance of these occult tumor cells should become apparent from large series of endoscopically treated patients. J. Surg. Oncol. 2010;102:863-867. (C) 2010 Wiley-Liss, Inc.
Original languageUndefined/Unknown
Pages (from-to)863-867
Number of pages5
JournalJournal of Surgical Oncology
Issue number7
Publication statusPublished - 2010

Cite this