title: Outcomes of cervical lymph node recurrence in patients with esophageal squamous cell carcinoma after esophagectomy with 2-field lymph node dissection.
abstract: OBJECTIVE
  The purpose of this study is to investigate the clinical characteristics, prognosis, and risk factors of patients in whom cervical lymph node cancer recurred after esophageal cancer surgery with 2-field lymph node dissection.
  
  
  METHODS
  Between 2000 and 2010, 471 consecutive patients who had undergone esophagectomy with 2-field lymph node dissection for esophageal squamous cell carcinoma were enrolled in this study.
  
  
  RESULTS
  Recurrence was seen in 96 patients. Isolated cervical lymph node recurrence (group A) developed in 21 patients, locoregional recurrence only and without cervical lymph node recurrence (group B) in 29, and distant recurrence with or without locoregional recurrence (group C) in 46 patients. The median times to recurrence after surgery in groups A, B, and C were 20, 16, and 12 months, respectively (P = .634). 2- and 5-year rates of isolated cervical lymph node recurrence were 4.1% and 5.6%, respectively. The median survival times from diagnosis of recurrence were 13, 7, and 5 months in groups A, B, and C, respectively. The difference in survival between groups A and C was statistically significant (P = .030). Upper thoracic esophageal cancer and positive recurrent laryngeal node at the time of initial surgery were independent risk factors for cervical recurrence-free survival as determined by univariate and multivariate analysis.
  
  
  CONCLUSIONS
  This study shows that 2-field lymph node dissection can be performed with an acceptable rate of cervical lymph node recurrence. Patients with isolated cervical lymph node recurrence demonstrated longer survival from diagnosis of recurrence than patients with other sites of recurrence.
authors: Division of Thoracic Surgery, Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors: Deok Heon
authors: DH
authors: Lee
authors: Hyeong Ryul
authors: HR
authors: Kim
authors: Dong Kwan
authors: DK
authors: Kim
authors: Seung-Il
authors: SI
authors: Park
authors: Yong-Hee
authors: YH
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision / Q000009:adverse effects / Q000401:mortality; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: 7; AJCC; American Joint Committee on Cancer; CI; CT; computed tomography; confidence interval