RT Journal Article
SR Electronic
T1 Clinical Research Regarding the Ratio of Lymph Node Metastasis and the Reasonable Extent of Lymphadenectomy in Middle Third Thoracic Esophageal Squamous Cell Carcinoma
JF Clinical Oncology and Cancer Research
JO Cancer Biol Med
FD China Anti-Cancer Association
SP 33
OP 38
DO 10.1007/s11805-010-0033-y
VO 7
IS 1
A1 XIE, Ming-ran
A1 LIN, Peng
A1 ZHANG, Xu
A1 CHEN, Jie-xin
A1 LIN, Yong-bin
A1 WEN, Zhe-sheng
A1 RONG, Tie-hua
A1 LI, Xiao-dong
A1 WANG, Jun-ye
A1 YU, Hui
YR 2010
UL http://www.cancerbiomed.org/content/7/1/33.abstract
AB OBJECTIVE To explore the extent of lymphadenectomy deemed reasonable by analyzing the influence of the regular patt ern and ratio of lymph node metastasis on the prognosis of the patients with middle third thoracic esophageal squamous cell carcinoma.METHODS Clinical data from 129 patients with middle third thoracic esophageal squamous cell carcinoma who underwent curative esophagectomy with modern two-field lymphadenectomy were retrospectively analyzed.RESULTS The rate of lymphatic metastasis in EC patients was 56.6% in all groups, and the ratio of lymph node metastasis (RLNM, i.e. positive nodes/total dissected nodes) was 11.3%, with a lymphatic metastasis rate of 43.4% in the superior mediastinum. The most commonly involved regions included the sites around the esophagus, the right recurrent laryngeal nerve and the left-sided blood vessels of stomach, as well as the cardia and the inferior tracheal protuberance. The main factors influencing lymphatic metastasis were the depth of tumor infiltration, differentiation of tumor cells and the size of the tumor. The 5-year survival rate for patients in the groups without lymphatic metastasis, with a RLNM ≤ 20%, and a metastasis ratio > 20% was 50.4%, 31.0% and 6.8%, respectively. The differences were statistically significant among the groups (P = 0.000).CONCLUSION The RLNM is one of the key factors affecting the prognosis of EC patients. For conventional therapy for patients with middle third thoracic esophageal carcinoma, modern 2-field lymphadenectomy, including node dissection in the bilateral superior mediastinum, should be performed.