Clinical surgery–internationalLocation and clinical impact of solitary lymph node metastasis in patients with thoracic esophageal carcinoma
Section snippets
Patients with a solitary positive node
Between 1970 and 2002, 652 patients with thoracic esophageal cancer underwent R0 esophagectomy with lymphadenectomy without any neoadjuvant treatment. A total of 237 (36%) patients showed no lymph node metastases and 91 (14%) patients showed a solitary lymph node metastasis. The patients with a solitary positive node consisted of 80 males (88%) and 11 females (12%), with a median age of 64 years (range 27 to 84 years).
Surgery and pathological examinations
All patients with untreated primary tumors underwent esophagectomy via
Comparison of clinicopathologic features between node-negative patients and solitary node-positive patients
Although overall survival did not show a statistically significant difference between the 2 groups, cause-specific survival revealed that patients with a solitary positive node showed a significantly worse survival than that of node-negative patients (Fig. 1).
Distribution of solitary positive nodes according to tumor location
The distribution of the location of solitary positive nodes was 10% in the cervix, 24% in the upper thorax, 19% in the lower thorax and 47% in the abdomen. A total of 39 (43%) of 91 patients had a solitary positive node in the thorax and
Comments
In the present study, we investigated the distribution of solitary positive lymph node metastasis in patients with thoracic esophageal carcinoma. We observed that 43% of positive nodes were present in an intra-thorax field. However, 57% of the patients showed extra-thorax metastasis, including 7 patients who showed a solitary node to a site opposite tumor location. Furthermore, for tumors in the upper and middle thorax, the initial nodes were distributed to the cervix, thorax, and abdomen.
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Cited by (9)
Subcarinal node metastasis in thoracic esophageal squamous cell carcinoma
2012, Annals of Thoracic SurgeryCitation Excerpt :Some researchers performed similar research and yielded the opposite results. No significant difference was found in survival concerning different stations of lymph node metastasis [20], and even distant lymph node metastasis was not a risk factor for poor survival [21]. In summary, longer tumor length, higher pathologic T stage, lower histologic grade, and positive lymph node metastases of other groups are associated with a higher frequency of subcarinal node metastasis.
Role of endosonography prior to Endoscopic treatment of Esophageal cancer
2018, Minerva ChirurgicaPrognostic significance of lymph node characteristics on survival in esophageal squamous cell carcinomas
2013, Wiener Klinische WochenschriftPrognostic significance of solitary lymph node metastasis in patients with squamous cell carcinoma of middle thoracic esophagus
2012, World Journal of Surgical Oncology
Supported in part by the 21st Century Center of Excellence Project and a Grant-in-Aid from the Ministry of Education, Science and Culture of Japan.