TY - JOUR
T1 - Distribution of lymph node metastases in esophageal carcinoma [TIGER study]: Study protocol of a multinational observational study
AU - Hagens, Eliza R. C.
AU - van Berge Henegouwen, Mark I.
AU - van Sandick, Johanna W.
AU - Cuesta, Miguel A.
AU - van der Peet, Donald L.
AU - Heisterkamp, Joos
AU - Nieuwenhuijzen, Grard A. P.
AU - Rosman, Camiel
AU - Scheepers, Joris J. G.
AU - Sosef, Meindert N.
AU - van Hillegersberg, Richard
AU - Lagarde, Sjoerd M.
AU - Nilsson, Magnus
AU - Räsänen, Jari
AU - Nafteux, Philippe
AU - Pattyn, Piet
AU - Hölscher, Arnulf H.
AU - Schröder, Wolfgang
AU - Schneider, Paul M.
AU - Mariette, Christophe
AU - Castoro, Carlo
AU - Bonavina, Luigi
AU - Rosati, Riccardo
AU - de Manzoni, Giovanni
AU - Mattioli, Sandro
AU - Garcia, Josep Roig
AU - Pera, Manuel
AU - Griffin, Michael
AU - Wilkerson, Paul
AU - Chaudry, M. Asif
AU - Sgromo, Bruno
AU - Tucker, Olga
AU - Cheong, Edward
AU - Moorthy, Krishna
AU - Walsh, Thomas N.
AU - Reynolds, John
AU - Tachimori, Yuji
AU - Inoue, Haruhiro
AU - Matsubara, Hisahiro
AU - Kosugi, Shin-Ichi
AU - Chen, Haiquan
AU - Law, Simon Y. K.
AU - Pramesh, C. S.
AU - Puntambekar, Shailesh P.
AU - Murthy, Sudish
AU - Linden, Philip
AU - Hofstetter, Wayne L.
AU - Kuppusamy, Madhan K.
AU - Shen, K. Robert
AU - Darling, Gail E.
AU - Sabino, Flávio D.
AU - Grimminger, Peter P.
AU - Meijer, Sybren L.
AU - Bergman, Jacques J. G. H. M.
AU - Hulshof, Maarten C. C. M.
AU - van Laarhoven, Hanneke W. M.
AU - Mearadji, Banafsche
AU - Bennink, Roel J.
AU - Annema, Jouke T.
AU - Dijkgraaf, Marcel G. W.
AU - Gisbertz, Suzanne S.
PY - 2019/7/4
Y1 - 2019/7/4
N2 - 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. Trial registration: NCT03222895, date of registration: July 19th, 2017.
AB - 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. Trial registration: NCT03222895, date of registration: July 19th, 2017.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85068550057&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31272485
U2 - https://doi.org/10.1186/s12885-019-5761-7
DO - https://doi.org/10.1186/s12885-019-5761-7
M3 - Article
C2 - 31272485
SN - 1471-2407
VL - 19
JO - BMC Cancer
JF - BMC Cancer
IS - 1
M1 - 662
ER -