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Assessment of cervical lymph node metastasis in the staging of thoracic esophageal carcinoma
Author(s) -
Kato Hoichi,
Igaki Hiroyasu,
Tachimori Yuji,
Watanabe Hiroshi,
Tsubosa Yasuhiro,
Nakanishi Yukihiro
Publication year - 2000
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/1096-9098(200008)74:4<282::aid-jso8>3.0.co;2-r
Subject(s) - medicine , mediastinum , carcinoma , radiology , esophagectomy , dissection (medical) , lymph node , lymph , metastasis , esophageal cancer , pathology , cancer
Background Cervical lymph node metastases (CLM) from esophageal carcinoma are regarded as a part of the M component of the TNM classification. Patients with CLM, however, can experience extended survival after cervical lymph node dissection, unlike patients with other M components. Methods Among 844 patients with thoracic esophageal carcinoma, 197 underwent esophagectomy with three‐field dissection of the cervical, mediastinal, and abdominal lymph nodes (3FD). The survival of patients with CLM was compared with that of patients with hematogenous metastasis (HM), and the prognostic value of CLM was assessed. Results The survival curve for patients with CLM was significantly better than that for patients with HM ( P = 0.002). Among the 197 patients who underwent 3FD, 46 (23.4%) had histologic CLM. Of the 165 patients without hematogenous metastases, 22 (13.3%) had histologic CLM. The survival curve for the patients with histologic CLM was not significantly differ from that for patients with mediastinal or abdominal lymph node metastasis ( P = 0.127, P = 0.155) by univariate analyses. Conclusions The significantly better survival of patients with CLM compared with that of patients with HM strongly suggests that CLM carries a prognosis different from the other M components in the staging of thoracic esophageal carcinoma. Because the survival curve for patients after 3FD was similar to that of patients with metastasis in the mediastinum or abdomen, we feel CLM should be included in the N component. J. Surg. Oncol. 2000;74:282–285. © 2000 Wiley‐Liss, Inc.