title: The clinical significance of subcarinal lymph node dissection in the radical resection of oesophageal cancer.
abstract: OBJECTIVE
  To explore the rule of subcarinal lymph node metastasis in thoracic oesophageal cancer and its clinical significance in the radical resection of oesophageal cancer.
  
  
  METHODS
  We retrospectively analysed 2223 patients with oesophageal cancer who were admitted to Henan Cancer Hospital during 2004-2011 and underwent surgery as the first treatment option. Routine subcarinal lymph node dissections were performed, and the sections from the resected lymph nodes were embedded in paraffin for routine pathological examination.
  
  
  RESULTS
  Subcarinal lymph node metastasis was observed in 200 patients (9%). Logistic regression analysis identified the following risk factors (P < 0.05): tumour location, depth of invasion into the oesophageal wall, tissue type, number of lymph node metastases, paraoesophageal lymph node metastasis (level 8 lymph nodes), left gastric cardiac lymph node metastasis. Unpaired t-test and χ(2)-test showed that more lymph node metastases, longer tumour length, deeper tumour invasion, middle oesophageal cancer, squamous-cell carcinoma, lower degree of differentiation, paraoesophageal lymph node metastasis and left gastric cardiac lymph node metastasis were associated with a higher frequency of subcarinal lymph node metastases (P < 0.05). Using the Kaplan-Meier method, recurrence and metastasis were shown to be more likely with solitary subcarinal lymph node metastasis than with solitary paraoesophageal lymph node metastasis (P = 0.001).
  
  
  CONCLUSIONS
  Tumour location, depth of invasion, pathological type, degree of differentiation and other factors are closely associated with subcarinal lymph node metastasis. Recurrence and metastasis after oesophageal dissection are more likely with subcarinal lymph node metastasis.
authors.affiliation: Department of Thoracic Surgery, Henan Cancer Hospital, Zheng Zhou University, Zheng Zhou, Henan, China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Ma
authors.forename: Yin
authors.initials: Y
authors.lastname: Li
authors.forename: Zhidan
authors.initials: Z
authors.lastname: Ding
authors.forename: Xianben
authors.initials: X
authors.lastname: Liu
authors.forename: Jinliang
authors.initials: J
authors.lastname: Xu
authors.forename: Jianjun
authors.initials: J
authors.lastname: Qin
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery*; D002454:Cell Differentiation; D016009:Chi-Square Distribution; D002681:China; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Oesophageal cancer; Oesophageal surgery; Subcarinal lymph node dissection