Status of Involved Lymph Nodes and Direction of Metastatic Lymphatic Flow Between Submucosal and T2‐4 Thoracic Squamous Cell Esophageal Cancers

Motoyama, Satoru; Maruyama, Kiyotomi; Sato, Yusuke; Usami, Shuetsu; Nakatsu, Toshinobu; Saito, Hajime; Minamiya, Yoshihiro; Ogawa, Jun–ichi

doi:10.1007/s00268-008-9781-8

Cited by 16 publications

(14 citation statements)

References 15 publications

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“…But their series included lower thoracic tumors and upper mediastinal lymphadenectomy was not routinely performed. The wide distribution of solitary lymph node metastasis was closely associated with the tumor site and unique features of lymphatic spread from the esophagus, which has been discussed in many previous reports [4,5,8,19,20]. In addition, middle thoracic tumors have a more obvious tendency to develop bidirectional metastasis than upper and lower thoracic tumors of the esophagus [1,19,20], so it is still hard to predict the location of solitary lymph node metastasis, even if sentinel navigation surgery is used [4].…”

Section: Discussionmentioning

confidence: 80%

Prognostic significance of solitary lymph node metastasis in patients with squamous cell carcinoma of middle thoracic esophagus

Chen

Xiao-fang

et al. 2012

World J Surg Onc

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BackgroundThe aim of this study is to compare clinical outcomes between patients with solitary lymph node metastasis and node-negative (N0) patients in squamous cell carcinoma of the middle thoracic esophagus.MethodsA series of 135 patients with squamous cell carcinoma of the middle thoracic esophagus were retrospectively investigated. There were 33 patients with solitary lymph node metastasis and 102 N0 patients. Skip metastasis in 33 patients with solitary lymph node metastasis was defined according to three criteria: Japanese Society for Esophageal Disease (JSED), American Joint Commission on Cancer (AJCC), and the anatomical compartment.ResultsIn 33 patients with solitary lymph node metastasis, skip metastasis was shown in 13, 23, and 8 patients according JSED, AJCC and anatomical compartment respectively. The 5-year survival rates for N0 patients and patients with solitary lymph node metastasis were 58% and 32% respectively (P =0.008). Multivariate analysis revealed that skip metastasis was not an independent prognostic factor.ConclusionsFor patients with middle thoracic esophageal squamous cell carcinoma, solitary lymph node metastasis has a negative impact on survival compared with N0 disease; skip metastasis, however, is comparable to N0 diseases in predicting prognosis.

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Section: Discussionmentioning

confidence: 80%

Prognostic significance of solitary lymph node metastasis in patients with squamous cell carcinoma of middle thoracic esophagus

Chen

Xiao-fang

et al. 2012

World J Surg Onc

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“…However, lymphatic metastasis seems to occur much less in superficial esophageal cancer, and studies by Hagen et al 8 . and Motoyama et al 9 . suggested that patterns of lymphatic metastasis differed according to the T stage of esophageal cancer.…”

Section: Introductionmentioning

confidence: 99%

Can common hepatic artery lymph node dissection be safely omitted in surgery for clinical T1N0 thoracic esophageal squamous cell carcinoma?

et al. 2012

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Common hepatic artery lymph node dissection is regarded as a standard procedure in esophageal cancer surgery because of aggressive lymphatic dissemination of esophageal cancer. However, lymph node dissection can prolong operation time and may be associated with complications such as chylous ascites. Here, we aimed to evaluate the effectiveness of common hepatic artery lymph node dissection in clinical T1N0 thoracic esophageal squamous cell carcinoma. Between 1996 and 2009, 1390 patients underwent surgery for esophageal cancer in our institution, and 209 were found to have clinical T1N0 disease. Exclusion criteria were nonsquamous carcinoma, double primary cancer, definite distant metastasis, administration of neoadjuvant treatment, and incomplete abdominal lymph node dissection. We retrospectively analyzed medical records, operative and pathologic data, and follow-up information. Forty-two patients were excluded from the study. Among the 167 enrolled patients, preoperative endoscopic ultrasound evaluation was performed in 160 patients. Fifty-two patients had distal esophageal or esophagogastric junction tumor. Surgery included 2 cases of tri-incisional esophagectomy, 17 cases of transhiatal esophagectomy, and 148 cases of two-field esophagectomy (Ivor Lewis operation). Common hepatic artery lymph node dissection was performed in all cases, and none of the patients had metastasis. Mean follow-up period was 35.4 ± 28.7 months. In-hospital mortality was one, and 5-year survival rate was 80.6%. Among the 15 patients with recurrence, there were two distant metastases and five distant and local recurrences but no intra-abdominal recurrence with common hepatic artery lymph node. Common hepatic artery lymph node dissection may be safely omitted in surgery for clinical T1N0 esophageal squamous cell carcinoma when preoperative evaluations including chest computed tomography, positron emission tomography and computed tomography, and esophagogastroduodenoscopy or endoscopic ultrasound are performed.

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“…One reason for that variation could be the difference in T stage (depth of tumour invasion) of the primary tumour. It was reported that the positivity rate for locoregional nodes increases from 0% for intra-epithelial tumours to 31%-56% for T1b, 58%-78% for T2, 74%-81% for T3, and 100% for T4 tumours [14][15][16] .…”

Section: Figurementioning

confidence: 99%

“…In addition, our study observed only the distribution of metastatic lymph nodes. In fact, elective nodal irradiation should consider tumour T stage, histology, and tumour length, among other factors 15,16 . Despite those limitations, ct is an important and common tool for ec care in nonsurgical patients.…”

Section: Figurementioning

confidence: 99%

Computed Tomography–Based Distribution of Involved Lymph Nodes in Patients with Upper Esophageal Cancer

Liu

et al. 2015

Current Oncology

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Status of Involved Lymph Nodes and Direction of Metastatic Lymphatic Flow Between Submucosal and T2‐4 Thoracic Squamous Cell Esophageal Cancers

Cited by 16 publications

References 15 publications

Prognostic significance of solitary lymph node metastasis in patients with squamous cell carcinoma of middle thoracic esophagus

Prognostic significance of solitary lymph node metastasis in patients with squamous cell carcinoma of middle thoracic esophagus

Can common hepatic artery lymph node dissection be safely omitted in surgery for clinical T1N0 thoracic esophageal squamous cell carcinoma?

Computed Tomography–Based Distribution of Involved Lymph Nodes in Patients with Upper Esophageal Cancer

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