Lymph Nodes Hold Clues to Esophageal Cancer Recovery

Although raised lymph nodes, or glands', are often associated with minor infections such as colds, they may also hold clues to the effect of treatment on each case of esophageal cancer. John Vincent Reynolds, a professor of surgery at the University of Dublin in Ireland, and his colleagues found that the success of treatment may be determined, in advance, by the presence of cancer cells in local lymph nodes. This is important as clinicians may now predict more accurately whether a patient is likely to survive after treatment for cancer of the esophagus.

The esophagus is a long muscular tube which transports food from the mouth to the stomach. Only 50 percent of people developing cancer of this structure will survive for three years, even with intensive treatment. Multimodal neoadjuvant therapy is the favoured treatment in most cases, and is characterised by the use of drugs and radiation to shrink the tumour before the patient undergoes surgery. Until now, doctors have typically examined the microscopic appearance of tumour cells to determine whether or not neoadjuvant therapy has worked.

Reynolds and his co-authors followed the progress of 243 patients, noting cancer spread to lymph nodes and the microscopic appearance of the cancer itself. After statistical analysis, the authors concluded that "a node-negative status is the major determinant of outcome following neoadjuvant chemoradiotherapy". It remains to be seen how node status may be incorporated into the standard system of grading esophageal tumours.

- by David Metcalfe.

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