title: Prognostic significance of solitary lymph node metastasis in patients with squamous cell carcinoma of middle thoracic esophagus.
abstract: BACKGROUND
  The aim of this study is to compare clinical outcomes between patients with solitary lymph node metastasis and node-negative (N0) patients in squamous cell carcinoma of the middle thoracic esophagus.
  
  
  METHODS
  A series of 135 patients with squamous cell carcinoma of the middle thoracic esophagus were retrospectively investigated. There were 33 patients with solitary lymph node metastasis and 102 N0 patients. Skip metastasis in 33 patients with solitary lymph node metastasis was defined according to three criteria: Japanese Society for Esophageal Disease (JSED), American Joint Commission on Cancer (AJCC), and the anatomical compartment.
  
  
  RESULTS
  In 33 patients with solitary lymph node metastasis, skip metastasis was shown in 13, 23, and 8 patients according JSED, AJCC and anatomical compartment respectively. The 5-year survival rates for N0 patients and patients with solitary lymph node metastasis were 58% and 32% respectively (P =0.008). Multivariate analysis revealed that skip metastasis was not an independent prognostic factor.
  
  
  CONCLUSIONS
  For patients with middle thoracic esophageal squamous cell carcinoma, solitary lymph node metastasis has a negative impact on survival compared with N0 disease; skip metastasis, however, is comparable to N0 diseases in predicting prognosis.
authors.affiliation: Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310033, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Wu
authors.forename: Qi-Xun
authors.initials: QX
authors.lastname: Chen
authors.forename: Xing-Ming
authors.initials: XM
authors.lastname: Zhou
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Mao
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Krasna
authors.forename: Li-Song
authors.initials: LS
authors.lastname: Teng
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016629:Esophagectomy / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000401:mortality*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate