Survival and clinical evaluation of salvage operation for cervical lymph node recurrence in esophageal cancer.
OBJECTIVE
Although extended lymphadenectomy for thoracic esophageal cancer is widely practiced in Japan, solitary supraclavicular lymph node recurrence (SCLR) has often become a problem. This study was designed to evaluate the survival and clinical benefit of salvage cervical lymphadenectomy.


METHODS
Between 1989 and 2001, 153 patients underwent esophagectomy for esophageal cancers. SCLR was identified in 5 (3.7%) patients and these five patients were examined retrospectively.


RESULTS
Surgical treatment was performed intensively for all patients. Two patients showed longterm survival for 7 years 3 months and 4 years, respectively. Four patients belonged to the good prognostic group but the other patient had poor prognosis from the viewpoint of both the pathological metastatic lymph node number and disease-free interval (DFI). There were no local recurrences but were a recurrent laryngeal nerve palsy in three patients associated with treatment.


CONCLUSIONS
Salvage cervical lymphadenectomy for SCLR should be performed positively by selecting each case carefully. Indication must be weighed against increased morbidity considering such indicators as the extent of metastatic lymph node numbers and DFI.
Komatsu
Shuhei
S
Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan. syuhei@mx.biwa.ne.jp
Shioaki
Yasuhiro
Y
Ichikawa
Daisuke
D
Hamashima
Takashi
T
Kan
Keitaro
K
Ueshima
Yasuo
Y
Koide
Kazuma
K
Lee
Chol Joo
CJ
Ikeda
Eito
E
Mutoh
Fumitaka
F
Kurioka
Hideaki
H
Oka
Takahiro
T
Yamagishi
Hisakazu
H
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D012086:Reoperation; D016879:Salvage Therapy