Prognosis of 121 Cases with Pathological Lymph Node Metastasis in the Abdomen from Thoracic Esophageal Squamous Cell Carcinoma after Curative Esophagectomy

• Maruyama Kiyotomi

  Department of Surgery, Akita University School of Medicine

• Motoyama Satoru

  Department of Surgery, Akita University School of Medicine

• Usami Shuetsu

  Department of Surgery, Akita University School of Medicine

• Yoshino Kei

  Department of Surgery, Akita University School of Medicine

• Nakatsu Toshinobu

  Department of Surgery, Akita University School of Medicine

• Ogawa Junichi

  Department of Surgery, Akita University School of Medicine

Bibliographic Information

Other Title

• 病理学的腹部リンパ節転移を有する胸部食道扁平上皮癌121例の予後

Abstract

Introduction:The prognosis of thoracic esophageal carcinoma with abdominal lymph node (LN) metastasis is a dismal one. Celiac LN involvement is defined in TNM classification as distant thoracic esophageal carcinoma metastasis. We report on the prognosis of thoracic esophageal carcinoma with abdominal LN metastasis. Methods:We reviewed retrospective clinicopathological data on 121 cases with positive abdominal LN metastasis from among 332 consecutive subjects undergoing subtotal esophagectomy with LN dissection for thoracic esophageal squamous cell carcinoma between 1995 and 2005. We evaluated the prognostic LN factor impact using univariate and multivariate analysis. Results:The right paracardiac node had the highest positivity, i.e., 47%. Cases with 5 or more positive LNs were most frequently at 40% among all positive LNs. Of these, 51 (42%) had positive LNs in the abdomen alone, 68 (56 in the mediastinum and 31 (26%) in the cervix. Overall 3-year survival of the 121 with abdominal LN metastasis was 53% and overall-5-year survival 39%. Overall 5-year survival for the 51 with LN metastasis in the abdomen alone was 56% and for the 70 with mediastinal and/or cervical LN metastasis 27%-a statistically significant difference. Overall 5-year survival among the 100 without distant LN metastasis was 42% and among the 21 with distant LN metastasis 26%. According to univariate analysis, T1/T2, a lower number of positive nodes (4 or fewer), negative cervical or mediastinal LN metastasis, and venous invasion were identified as significant predictors for favorable survival. According to multivariate analysis, good prognostic factors were cases aged 65 and under, T1/T2, and a lower number of positive nodes (4 or fewer). Conclusions:Among abdominal LN metastasis cases, those with positive LNs in the abdomen alone and with 4 or fewer positive nodes showed acceptable overall survival after curative esophagectomy.

Journal

• The Japanese Journal of Gastroenterological Surgery

  The Japanese Journal of Gastroenterological Surgery 44 (1), 1-9, 2011

  The Japanese Society of Gastroenterological Surgery

Keywords

• esophageal cancer
• lymph node metastasis
• prognosis
• surgery
• prognostic factors

Details

• CRID: 1390282679895896320
• NII Article ID: 130004907940
• DOI: 10.5833/jjgs.44.1
• ISSN: 13489372
• ISSN: 03869768
• Web Site: https://www.jstage.jst.go.jp/article/jjgs/44/1/44_1_1/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2011163644
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed