[Diagnostic relevance of lymph node size after 2-field lymph node excision in esophagus carcinomas]

In 22 patients with thoracoabdominal esophagectomy and 2-field lymphadenectomy the lymph nodes (LN) were dissected according to a standardized protocol and classified in five groups regarding their size. 407 of 675 dissected LN (60.3%) were < 5 mm. 89.4% of the metastatic LN were < 10 mm although LN > 10 mm showed significantly more metastases than LN < 10 mm. Since diagnostic imaging defines metastatic LN by a diameter > 10 mm these results demonstrate the inaccuracy to evaluate preoperatively the cN-status. These results also support the need of a systematic lymphadenectomy in patients with esophageal cancer.