150. PATTERN OF LYMPH NODE RECURRENCE AFTER NEOADJUVANT CHEMORADIOTHERAPY AND MODIFIED EN BLOC ESOPHAGECTOMY

Abstract Background Esophageal cancer is an aggressive malignancy with high incidence of lymph node metastasis and recurrence rate even after neoadjuvant treatment radical resection. Previous study has shown that modified en bloc esophagectomy (mEBE) improves survival for esophageal squamous cell carcinoma (ESCC) chemoradiotherapy (nCRT). In this study, we aim to investigate the pattern nCRT+mEBE. Methods The data patients who received nCRT followed by curative surgical resection ESCC were retrospectively reviewed. mEBE includes ‘mesophagus’ dissection bilateral recurrent laryngeal nerve dissection, whereas conventional (CE) only requires periesophageal tissues close esophagus. recurrence, especially (cervical, upper mediastinum, infra-carina, abdominal), compared between CE mEBE, stratification according pathological stage (ypT0N0 or not.) Results A total 221 (CE, n = 181; 40) included. Mediastinal was noted in 16.0% 7.5% respectively (p 0.166). ypT0N0 CE, 6.0% had mediastinum no mediastinal 0.329). non-ypT0N0 15.3% 8.2% infra-carina recurrences, 12.0% 0% 0.283). There cervical/abdominal recurrences 6.6%/7.2% 15.0%/5.0% 0.080/0.618). Conclusion Although there significant difference observed (1) 6% developed implying possibility understaging CE; (2) suggesting necessity mesoesophagus (3) cervical indicating should be considered selected patients.