ABSTRACT
BACKGROUND: Survival among patients with esophageal cancer with stage IV nonregional lymphadenopathy treated with neoadjuvant therapy and surgical resection is not well described. This study aimed to compare the survival outcomes of patients with nonregional lymphadenopathy with a propensity-matched cohort of patients with locoregional disease. METHODS: This was a retrospective cohort analysis of a prospectively maintained database from a regional upper gastrointestinal cancer network in Quebec, Canada. From January 2010 to December 2022, patients with radiologically suspicious nonregional retroperitoneal or supraclavicular lymphadenopathy were identified. Using 1:1 propensity score matching, a control group without nonregional disease was created. RESULTS: Of the 1235 patients identified, 39 met the inclusion criteria and were allocated to the study group of whom 35 of 39 (89%) had adenocarcinoma. Retroperitoneal and supraclavicular lymphadenopathy occurred in 26 of 39 patients (67%) and 13 of 39 patients (33%). Of the 39 patients, 34 (87%) received neoadjuvant chemotherapy, and 5 (13%) received chemoradiotherapy. After resection, ypN0 of nonregional lymph node stations occurred in 21 of 39 patients (54%). When comparing the study group with a matched non-stage IV control group, the median overall survival was similar in patients with retroperitoneal lymphadenopathy (21.0 months [95% CI, 8.0-21.0] vs 27.0 months [95% CI, 13.0-41.0]; P = .262) but not with supraclavicular disease (13.0 months; 95% CI, 8.0-18.0; P = .039). The median follow-up intervals were 40.1 months (95% CI, 1.0-83.0) for the study group and 70.0 (95% CI, 33.0-106.0) for the control groups. CONCLUSION: Compared with a matched cohort of patients with similar disease burden but not stage IV disease, retroperitoneal lymphadenopathy did not negatively affect survival outcomes. Multimodal curative intent therapy may be appropriate in select cases.
Subject(s)
Adenocarcinoma , Esophageal Neoplasms , Lymphadenopathy , Neoadjuvant Therapy , Neoplasm Staging , Propensity Score , Humans , Esophageal Neoplasms/therapy , Esophageal Neoplasms/mortality , Esophageal Neoplasms/pathology , Male , Female , Middle Aged , Retrospective Studies , Aged , Lymphadenopathy/therapy , Adenocarcinoma/therapy , Adenocarcinoma/mortality , Adenocarcinoma/pathology , Neoadjuvant Therapy/statistics & numerical data , Esophagectomy , Survival Rate , Quebec/epidemiologyABSTRACT
A retrospective observational study was conducted to evaluate open-access journals in obstetrics and gynaecology, published between 2011 and 2019. Journals were classified based on their registration in open-access journal directories. Of 176 journals, 47 were not registered. Journals registered in the Directory of Open Access Journals (DOAJ) demonstrated good overall quality, and their journal metrics were significantly higher than those of non-registered journals or journals registered in other directories. The lack of editor names and indexing information on a journal's website are the most distinctive features of non-registered journals. Non-registration in an open-access journal directory indicates a lack of transparency and may ultimately indicate that a journal is predatory.
