Characteristics of lymph node metastasis in thoracic esophageal squamous cell carcinoma: A study of 407 patients
- VernacularTitle:胸段食管鳞状细胞癌患者淋巴结转移特点：407 例临床分析
- Author:
Jian CUI
1
;
Xiao SUN
1
;
Tianyi SUI
1
;
Ao LIU
1
;
Wenjie JIAO
1
Author Information
1. Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong, P.R.China
- Publication Type:Journal Article
- Keywords:
Esophageal cancer;
esophagectomy;
lymph node metastasis;
risk factors
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(09):1063-1069
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the characteristics and risk factors of lymph node metastasis in thoracic esophageal squamous cell carcinoma (ESCC). Methods The clinical data of 407 patients with ESCC who underwent radical resection of esophageal carcinoma from December 2012 to October 2018 in our hospital were retrospectively analyzed. There were 390 males and 17 females with a median age of 63 (38-82) years. Esophageal lesions were found in 26 patients of upper thoracic segment, 190 patients of middle thoracic segment and 191 patients of lower thoracic segment. Results Among the patients, 232 (57.0%) were found to have cervical, thoracic and/or abdominal lymph node metastasis. The lymphatic metastasis rates of cervical, upper, middle, lower mediastinal nodes and abdominal nodes were 0.7%, 8.8%, 21.4%, 16.7% and 37.1%, respectively. The adjacent lymph node metastasis alone occurred in 50.0% patients, and the multistage or skip lymph node metastasis accounted for 29.3% and 20.7%, respectively. Multivariate analysis showed that the length of esophageal lesion, T stage, degree of tumor differentiation, vascular cancer embolus and nerve invasion were independent risk factors for lymph node metastasis. Conclusion The rates of lymph node metastasis are similar in the upper, middle and lower thoracic ESCC. The main pattern of lymph node metastasis is the adjacent lymph node metastasis, followed by multistage and skip lymph node metastases. The length of esophageal lesion, T stage, degree of tumor differentiation, vascular cancer embolus and nerve invasion are independent factors for lymph node metastasis. The operation and dissection range should be selected according to the location of tumor and the characteristics of the lesion.
