Subcarinal node metastasis in thoracic esophageal squamous cell carcinoma

Area of Science:

• Oncology
• Surgical Oncology
• Pathology

Background:

• Subcarinal lymph node metastasis is a frequent occurrence in esophageal cancer.
• The necessity of subcarinal node sampling/dissection in superficial thoracic esophageal squamous cell carcinoma is debated.
• This study examines subcarinal node metastasis in esophageal squamous cell carcinoma (ESCC).

Purpose of the Study:

• To determine the frequency of subcarinal node metastasis in ESCC.
• To identify factors associated with subcarinal node metastasis.
• To evaluate the clinical significance of subcarinal node metastasis in thoracic ESCC.

Main Methods:

• Retrospective analysis of 1,812 patients with thoracic ESCC who underwent esophagectomy.
• Data collected from the Cancer Center of Sun Yat-sen University.
• Surgical procedures included left transthoracic, Ivor-Lewis, and cervical-thoracoabdominal approaches.

Main Results:

• The incidence of subcarinal node metastasis was 10.0%.
• Factors associated with increased subcarinal metastasis include longer tumor length, higher pathologic T stage, lower histologic grade, and positive non-subcarinal lymph nodes (p<0.05).
• Patients with isolated subcarinal node metastasis had a significantly lower 5-year survival rate (25.3%) compared to those with isolated paraesophageal node metastasis (39.6%, p<0.05).

Conclusions:

• Longer tumor length, advanced pathologic T stage, lower histologic grade, and positive non-subcarinal lymph node metastases are linked to a higher frequency of subcarinal node metastasis.
• Subcarinal node metastasis signifies a poorer prognosis in thoracic ESCC patients compared to paraesophageal node metastasis.