RT Journal Article
SR Electronic
T1 Analysis of Lymph Node Metastases of 1,526 Cases with Thoracic Esophageal and Cardiac Carcinomas: A Random Sampling Report from the Fourth Hospital of Hebei Medical University from 1996 to 2004
JF Chinese Journal of Clinical Oncology
JO Cancer Biol Med
FD China Anti-Cancer Association
SP 437
OP 442
DO 10.1007/s11805-008-0437-0
VO 5
IS 6
A1 Wei Liu
A1 Xishan Hao
A1 Yong Chen
A1 Haixin Li
A1 Shijie Wang
A1 Peizhong Wang
A1 Ying Jin
A1 Liyun Guan
A1 Qian Fan
A1 Linan Song
A1 Yumin Ping
A1 Xianli Meng
A1 Rui Wang
A1 Junfeng Liu
A1 Xiaoling Wang
YR 2008
UL http://www.cancerbiomed.org/content/5/6/437.abstract
AB OBJECTIVE To summarize the regular pattern and state of lymph node metastasis of patients with esophageal and cardiac carcinomas, so as to analyze factors influencing lymph node metastasis.METHODS Clinical data collected from 1,526 thoracic esophageal and cardiac carcinoma patients who were admitted in the Fourth Hospital of Hebei Medical University during a period from January 1996 to December 2004, were randomly selected and an Access Database of the patient’s information was set up. Eight clinico-pathologic factors, including the patient’s age, tumor location and size, pathological classification, the depth of tumor invasion, vascular tumor embolus (VTE), the state of surrounding organ encroachment and the status of tumor residues, were identified. A correlation between these factors and metastases was statistically analyzed using SPSS13.0 software.RESULTS Lymph node metastatic sites from esophageal carcinomas included the thoracic and abdominal cavity. Lymph node metastasis from the superior esophageal carcinomas mainly occurred in the neck and thoracic cavity. There was a two-way lymph node metastasis in the patients with the middle esophageal carcinoma. The inferior esophageal carcinomas mainly metastasized to the paraesophageal, paragastric cardia, and left gastric artery lymph nodes. The rate and degree of the metastasis from the inferior esophageal carcinomas were significantly higher compared to those of the superior and the middle esophageal carcinomas (P < 0.0125).The degree of abdominal lymph node metastasis from carcinomas of the gastric cardia was significantly higher compared with that of esophageal carcinomas. In the group with carcinoma of the gastric cardia, the rate and degree of the lymph node metastases in the paragastric cardia and left gastric artery were significantly higher compared to the group with esophageal carcinoma (P < 0.05). Paraesophageal lymph node metastasis from carcinomas of the gastric cardia in the thoracic cavity frequently occurred, too, and the degree of the metastasis was similar to that of esophageal carcinoma. There was no significant difference in the rate and degree of the paraesophageal lymph-node metastasis between the group with carcinoma of the gastric cardia compared to those with esophageal carcinoma (P > 0.05). Multifactorial logistic regression analysis showed that the tumor size, depth of tumor encroachment, VTE, and tumor residues could all bring about obvious impact on lymph-node metastases (P < 0.05).CONCLUSION Lymph node metastasis from superior esophageal carcinomas mainly occurs in the neck and thoracic cavity. The middle esophageal carcinomas presented a two-way lymph-node metastasis (both the upwards and the downwards), and the lymph node metastasis from inferior esophageal carcinomas mainly occurred in the thoracic and abdominal cavities. The metastases of carcinoma of the gastric cardia were most commonly found in the abdominal cavity, with frequent paraesophageal lymph-node metastasis. The sufficient attention should be paid to neck lymph node clearance in cases of esophageal carcinoma. What is of the greatest concern is the clearance of the left gastric artery lymph nodes, and also in cases of gastric cardia carcinoma, clearance, the paraesophageal lymph nodes. With an increase in the tumor size and depth of tumor encroachment, and occurrence of VTE and tumor residual cells, the risk of lymph node metastasis is significantly raised (P < 0.05).