Supraclavicular lymph node metastasis: a controversy in the surgical treatment of esophageal cancer
10.3760/cma.j.cn115610-20240802-00371
- VernacularTitle:锁骨上淋巴结转移在食管癌外科治疗中的争议
- Author:
Haibo SUN
1
;
Hiroyuki DAIKO
;
Wenqun XING
Author Information
1. 郑州大学附属肿瘤医院（河南省肿瘤医院）胸外科，郑州;450008
- Publication Type:Journal Article
- Keywords:
Esophageal neoplasms;
Supraclavicular lymph node metastasis;
Surgical therapy;
Combined modality therapy;
Controversy
- From:
Chinese Journal of Digestive Surgery
2024;23(10):1295-1301
- CountryChina
- Language:Chinese
-
Abstract:
Clinical staging is an important reference for treatment decisions and a key factor affecting the prognosis of patients. As one of the most important international staging criteria, the 12 th edition of classification of esophageal cancer of Japan Esophageal Society (JES) has been applied in clinical practice since 2022. Compared with the previous classification of esophageal cancer of JES, the N staging in 12 th edition of classification of esophageal cancer is defined as the number of lymph node metastases, rather than the station of the metastatic lymph nodes according to the tumor location. It is noteworthy that the 12 th edition of classification of esophageal cancer classifies supraclavicular lymph nodes as M1a stage, and M1a stage as well as N2-N3 stages are classified in the same clinical stage, which means that the Japanese scholars still believe that supraclavicular lymph node metastasis is not a contraindication to surgery for thoracic esophageal cancer. Compared with the esophageal cancer staging criteria jointly issued by the International Anti-Cancer Alliance and the American Cancer Federation, it is controversial that whether esophageal cancer patients with supraclavicular lymph node metastasis can receive surgical treatment. Since esophageal squamous cell carcinoma in China is the main pathological type as in Japan, a clear understanding and answer to the above question is of great significance in guiding the clinical diagnosis and treatment of esophageal cancer. The authors consult relevant literature and combine it with clinical practice to explore the controversy of supraclavicular lymph node metastasis in the treatment of esophageal cancer, aiming to provide reference for the accurate definition of metastatic lymph nodes in esophageal cancer, as well as the precise staging and optimal treatment mode for patients.
