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Lymph node enlargement after definitive chemoradiotherapy for clinical stage I esophageal squamous cell carcinoma.
[esophageal squamous cell carcinoma]
Chemoradiotherapy
(
CRT
)
is
an
effective
modality
for
stage
I
esophageal
squamous
cell
carcinoma
(
ESCC
)
.
However
,
salvage
treatments
are
often
required
even
if
complete
response
(
CR
)
has
been
achieved
.
To
this
end
,
it
is
important
to
accurately
diagnose
lymph
node
or
other
organ
metastatic
recurrences
.
Note
that
lymph
node
enlargements
(
except
metastatic
recurrence
)
are
often
detected
during
the
follow-up
period
after
CRT
.
The
purpose
of
this
study
was
to
elucidate
the
clinical
characteristics
of
lymph
node
enlargement
after
CRT
.
In
this
retrospective
cohort
study
,
patients
diagnosed
with
stage
I
(
T
1
[
submucosal
invasion
]
N
0
M
0
)
ESCC
were
treated
with
cisplatin
and
5
-
fluorouracil
concurrently
with
radiotherapy
.
A
total
of
55
patients
were
enrolled
in
the
study
from
February
2006
to
August
2011
.
The
median
follow-up
period
was
46
months
.
The
3
-
year
overall
and
progression-free
survival
rates
were
90
.
7
%
and
71
.
2
%
,
respectively
,
and
the
CR
rate
was
87
.
2
%
(
48
/
55
)
.
Nine
of
the
48
CR
patients
were
finally
diagnosed
with
recurrences
,
including
7
lymph
node
metastases
and
2
local
recurrences
.
Lymph
node
enlargement
was
initially
identified
in
20
of
the
total
55
patients
during
the
follow-up
;
9
patients
were
finally
diagnosed
with
lymph
node
recurrence
,
whereas
11
patients
had
benign
reactive
lymph
node
enlargement
.
The
present
study
demonstrated
the
high
incidence
of
enlarged
lymph
nodes
after
CRT
for
stage
I
ESCC
.
It
is
important
to
accurately
distinguish
between
benign
lymph
node
enlargement
and
recurrent
lymph
nodes
to
avoid
unnecessary
salvage
treatments
.
Diseases
Validation
Diseases presenting
"enlarged lymph nodes"
symptom
esophageal adenocarcinoma
esophageal squamous cell carcinoma
hodgkin lymphoma, classical
lymphangioleiomyomatosis
scrub typhus
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