[Characteristics of lymph node metastasis of squamous cell carcinoma of thoracic esophagus and its clinical significance].
OBJECTIVE
To study the characteristics of lymph node metastases of squamous-cell carcinoma of thoracic esophagus and its influence on patients' prognosis and find reasonable dissecting approaches of lymph nodes.


METHODS
To analyse retrospectively the clinical materials of 243 patients who had undergone resection of squamous-cell carcinoma of thoracic esophagus.


RESULTS
Lymph node metastases was found in 110 of the 243 treated patients (45.3%). In 3,813 lymph nodes dissected, metastases existed in 400 (10.5%). The cancer cells disseminated upward and downward to lymph nodes along the esophagus. Tumor differentiation and the depth of tumor invasion were factors influencing lymph node metastases, but the length of tumor was not. The 5-year survival rate of the patients with lymph node metastasis was 16.4%, being much lower than that of patients with no lymph node metastasis (51.9%). The numbers of lymph node metastases had little influence on patients' prognosis.


CONCLUSIONS
Because of the different upward and downward spreading of esophageal cancer cells to the lymph nodes, different lymph node dissecting approaches should be taken. The thoracic, and abdominal regional (two fields) lymph nodes dissection could be appropriate to esophageal carcinoma of the lower thoracic segment, and the cervical, thoracic and abdominal (three fields) lymph node dissection should be done for patients with earlier esophageal carcinoma of upper or middle thoracic segments.
Wang
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Y
Department of Thoracic Surgery, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Wang
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L
Zhang
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D
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000556:secondary*; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis