Lymph node metastasis in thoracic esophageal carcinoma

Area of Science:

• Oncology
• Surgical Oncology
• Thoracic Surgery

Background:

• Thoracic esophageal carcinoma is a significant cause of cancer mortality.
• Lymph node metastasis is a critical prognostic factor in esophageal cancer.
• The role of neck lymph node dissection in thoracic esophageal carcinoma requires further clarification.

Purpose of the Study:

• To evaluate the impact of transthoracic esophagectomy with comprehensive lymphadenectomy on survival outcomes.
• To determine the prevalence and prognostic significance of lymph node metastasis in different regions (neck, mediastinum, abdomen).
• To assess the necessity of including neck lymph nodes in regional lymph node dissection for thoracic esophageal carcinoma.

Main Methods:

• Retrospective analysis of 79 patients with thoracic esophageal carcinoma.
• Transthoracic esophagectomy with neck, mediastinal, and abdominal lymphadenectomy.
• Assessment of operative mortality, lymph node metastasis rates, and 5-year survival.
• Statistical analysis of survival rates based on lymph node involvement in different regions.

Main Results:

• Operative mortality rate was 3.8%.
• Lymph node metastasis was observed in 72.2% of patients.
• Positive nodes were found in 50.0% of pT1 carcinoma cases.
• 5-year survival for patients with positive nodes was 33.6%.
• Neck (36.7%), mediastinal (59.5%), and abdominal (41.8%) lymph node involvement showed similar 5-year survival rates (30.0%, 24.4%, 38.4% respectively), with no statistically significant differences.

Conclusions:

• Neck lymph nodes should be considered regional lymph nodes in thoracic esophageal carcinoma.
• Wide lymph node dissection, encompassing the neck, improves long-term survival.
• Comprehensive surgical staging and treatment are vital for managing thoracic esophageal carcinoma.