title: Prognostic factors in patients with squamous oesophageal cancer associated with solitary lymph node metastasis after oesophagectomy and extended lymphadenectomy.
abstract: It is not fully understood whether oesophageal cancer, associated with solitary lymph node metastasis, is still a local disease or already a systemic one. Among 283 patients with squamous oesophageal cancer who underwent oesophagectomy and 3-field lymphadenectomy, 37 patients had single metastasized nodes. Clinicopathologic factors, following Japanese Guideline for the Clinical and Pathological studies on Carcinoma of the Esophagus, related to survival and pre-operative predictability of nodal involvement was studied. Five-year survival was 48%. Initial pattern of recurrence was mostly haematogenous. Among the factors related to survival, grade of lymph node metastasis (pN1 vs. pN2, pN3, p=0.006) was more closely related than depth of invasion (pT1, pT2 vs. pT3, pT4, p=0.037). Five-year survival was 71.7% for pN1 patients, whereas it was 22% for pN2 or pN3 patients. Of the metastasized nodes 65% were <10 mm, and 27% was <5 mm in the maximum diameter. Oesophageal cancer is still a local disease in half of the patients with a solitary metastasized node. For these patients, dissection along the recurrent laryngeal nerve is necessary to retrieve the node possibly metastasized.
authors.affiliation: Department of Gastroenterological Surgery, Osaka City University Medical School, Japan. jumbo@msic.med.osaka-cu.ac.jp
authors.forename: Masashi
authors.initials: M
authors.lastname: Takemura
authors.forename: Harushi
authors.initials: H
authors.lastname: Osugi
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Takada
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Masayuki
authors.initials: M
authors.lastname: Higashino
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D015996:Survival Rate