title: Does recurrent laryngeal nerve lymph node metastasis really affect the prognosis in node-positive patients with squamous cell carcinoma of the middle thoracic esophagus?
abstract: BACKGROUND
  Recurrent laryngeal nerve (RLN) lymph node metastasis used to be shown a predictor for poor prognosis in esophageal squamous cell carcinoma. The purpose of this study was to evaluate the prognostic impact of RLN node metastasis and the number of metastatic lymph nodes in node-positive patients with squamous cell carcinoma of middle thoracic esophagus.
  
  
  METHODS
  A cohort of 235 patients who underwent curative surgery for squamous cell carcinoma of middle thoracic esophagus was investigated. The prognostic impact was evaluated by univariate and multivariate analyses.
  
  
  RESULTS
  Lymph node metastasis was found in 133 patients. Among them, 81 had metastatic RLN nodes, and 52 had at least one positive node but no RLN nodal involvement. The most significant difference in survival was detected between patients with metastatic lymph nodes below and above a cutoff value of six (P < 0.001). Multivariate analysis revealed that the number of metastatic lymph nodes was a significant factor associated with overall survival (P < 0.001), but RLN lymph node metastasis was not (P = 0.865).
  
  
  CONCLUSIONS
  RLN Lymph node metastasis is not, but the number of metastatic nodes is a prognostic predictor in node-positive patients with squamous cell carcinoma of the middle thoracic esophagus.
authors.affiliation: Department of Thoarcic Surgery, Zhejinang Cancer Hospital, 38 Guangji Road, Hangzhou 310022, China. wujiephd729@126.com.
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
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012009:Recurrent Laryngeal Nerve / Q000473:pathology*; D012189:Retrospective Studies