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Lymph node metastasis in resectable esophageal cancer
S Abe1, M Tachibana, M Shiraishi
1Second Department of Surgery, Shimane Medical University, Izumo, Japan.
The Journal of Thoracic and Cardiovascular Surgery
|August 1, 1990
Summary
Lymph node metastasis significantly impacts survival in esophageal epidermoid carcinoma. Even limited metastasis drastically reduces 5-year survival rates, suggesting limited benefit from aggressive treatment in advanced cases.
Area of Science:
- Oncology
- Surgical Oncology
Background:
- Esophageal cancer, specifically epidermoid carcinoma, presents a significant challenge in treatment and prognosis.
- Lymph node metastasis is a critical factor influencing patient outcomes in various cancers.
Purpose of the Study:
- To evaluate the prognostic significance of lymph node metastasis in patients with locally resectable epidermoid carcinoma of the esophagus.
- To correlate the extent of lymph node involvement with 5-year survival rates.
Main Methods:
- Retrospective analysis of 41 patients diagnosed with locally resectable epidermoid carcinoma of the esophagus.
- Assessment of lymph node metastasis status and correlation with survival data.
Main Results:
- A 5-year survival rate of 50.9% was observed with no or single lymph node metastasis.
- Survival decreased to 29.8% when metastasis was confined to one anatomic compartment.
- Patients with metastasis to two or more nodes had significantly poorer outcomes, with all dying within 3-4 years.
Conclusions:
- Lymph node metastasis is a strong negative prognostic indicator in resectable esophageal epidermoid carcinoma.
- Even limited nodal involvement significantly reduces survival, questioning the universal benefit of nodal dissection.
- Cervical or abdominal node involvement suggests a poor prognosis, potentially favoring conservative management.