Clinical implications of cervical lymph node metastasis patterns in thoracic esophageal cancer.
OBJECTIVE
The authors attempt to clarify the clinical implications of cervical lymph node metastases from thoracic esophageal cancers.


BACKGROUND
Cervical lymph node metastases from thoracic esophageal cancer have been considered to be incompatible with curative resection. However, recent studies have demonstrated that cure is achievable in patients with such metastases.


METHODS
Patterns of esophageal cancer metastasis to the cervical nodes and long-term results after tumor resection were investigated in 23 patients undergoing bilateral cervical lymphadenectomy for treatment of thoracic esophageal cancer.


RESULTS
The number of positive nodes per patient was significantly greater (p < 0.05) in lower esophageal cancers (median: 15) than in upper or mid esophageal cancers (median: 2.5). Simultaneous metastases to three nodal regions (the neck, mediastinum, and abdomen) were significantly more common (p < 0.001) in lower esophageal tumors (88.9%) than in upper and mid esophageal lesions (7.1%). Although the overall 5-year survival rate was 16.5%, long-term survival was achieved only in patients with upper or mid esophageal cancer.
Nishimaki
T
T
First Department of Surgery, Niigata University School of Medicine, Japan.
Tanaka
O
O
Suzuki
T
T
Aizawa
K
K
Hatakeyama
K
K
Muto
T
T
D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D015995:Prevalence; D015996:Survival Rate; D013909:Thorax