title: Therapeutic strategy for esophageal cancer based on solitary lymph node metastasis.
abstract: OBJECTIVE
  It is essential to perform appropriate lymph node dissection in esophageal cancer. However, it may be beneficial if lymph node dissection could be minimized to reduce the surgical stress.
  
  
  METHODS
  Between April 1992 and March 2005, 121 esophageal cancer patients (42 patients with solitary lymph node metastasis and 79 N0 patients) were enrolled. The survival time, distribution of solitary lymph node metastasis and the pattern of recurrence were evaluated.
  
  
  RESULTS
  The distribution of solitary lymph node metastasis was extensively observed in cervical, thoracic and abdominal cavities and the site of lymph node recurrence could even be detected in non-regional lymph nodes in N0 patients. It was difficult to predict the site of initial lymph node metastasis in patients with esophageal cancer.
  
  
  CONCLUSIONS
  Systemic lymph node dissection for regional lymph nodes is recommended for resectable esophageal cancer as the concept of sentinel lymph nodes has not yet been proven.
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan. s0714@med.yokohama-cu.ac.jp
authors.forename: Chikara
authors.initials: C
authors.lastname: Kunisaki
authors.forename: Hrochika
authors.initials: H
authors.lastname: Makino
authors.forename: Jun
authors.initials: J
authors.lastname: Kimura
authors.forename: Takashi
authors.initials: T
authors.lastname: Oshima
authors.forename: Shoichi
authors.initials: S
authors.lastname: Fujii
authors.forename: Ryo
authors.initials: R
authors.lastname: Takagawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Kosaka
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Ono
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Akiyama
authors.forename: Itaru
authors.initials: I
authors.lastname: Endo
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D015996:Survival Rate; D016896:Treatment Outcome