J Korean Med Sci.  2014 Feb;29(2):217-223. 10.3346/jkms.2014.29.2.217.

Patterns of Lymph Node Recurrence after Radical Surgery Impacting on Survival of Patients with pT1-3N0M0 Thoracic Esophageal Squamous Cell Carcinoma

• Chen XL
• Chen TW
• Fang ZJ
• Zhang XM
• Li ZL
• Li H
• Tang HJ
• Zhou L
• Wang D
• Zhang Z

• KMID: 1789978
• DOI: http://doi.org/10.3346/jkms.2014.29.2.217

Abstract

The aim of this study was to investigate how patterns of lymph nodes recurrence after radical surgery impact on survival of patients with pT1-3N0M0 thoracic esophageal squamous cell carcinoma. One hundred eighty consecutive patients with thoracic esophageal squamous cell carcinoma underwent radical surgery, and the tumors were staged as pT1-3N0M0 by postoperative pathology. Lymph nodes recurrence was detected with computed tomography 3-120 months after the treatment. The patterns of lymph nodes recurrence including stations, fields and locations of recurrent lymph nodes, and impacts on patterns of survival were statistically analyzed. There was a decreasing trend of overall survival with increasing stations or fields of postoperative lymph nodes involved (all P<0.05). Univariate analysis showed that stations or fields of lymph nodes recurrence, and abdominal or cervical lymph nodes involved were prognostic factors for survival (all P<0.05). Cox analyses revealed that the field was an independent factor (P<0.05, odds ratio=2.73). Lymph nodes involved occurred predominantly in cervix and upper mediastinum (P<0.05). In conclusion, patterns of lymph node recurrence especially the fields of lymph nodes involved are significant prognostic factors for survival of patients with pT1-3N0M0 thoracic esophageal squamous cell carcinoma.

Keyword

Esophageal Squamous Cell Carcinoma; Thorax; Lymph Node Recurrence; Tomography, X-Ray Computed; Radical Esophagectomy

MeSH Terms

Aged
Aged, 80 and over
Carcinoma, Squamous Cell/mortality/pathology/*surgery
Esophageal Neoplasms/mortality/pathology/*surgery
Female
Follow-Up Studies
Humans
Lymph Nodes/*pathology
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Recurrence, Local
Neoplasm Staging
Odds Ratio
Postoperative Period
Proportional Hazards Models
Survival Analysis
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Cumulative survivals during follow-up. The impacts of stations (A) and fields (B) of recurrent lymph node (LN), and abdominal (C) or cervical (D) lymph nodes involved on the survival of patients with pT1-3N0M0 thoracic esophageal squamous cell carcinoma after radical surgery. In A, S1, S2 and S3 represent that the stations of lymph nodes involved are 1 to 2, 3 to 6, and ≥ 7, respectively. In B, 1, 2 and 3 are the number of the fields of lymph nodes involved. LNM, lymph node metastasis.

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