Abstract
Lymph node metastasis is well-known as the most important prognostic indicator for esophageal carcinomas, and an accurate assessment of positive metastasis can only be made after total lymphadenectomy around the esophagus. However, prior to the development of 3-field lymph node dissection in Japan, no such operation existed for ascertaining the full positivity distribution. We report herein the results of a restrospective study conducted on 70 patients who underwent subtotal esophagectomy with 3-field dissection to discover the patterns of lymph node metastasis from carcinoma in the thoracic esophagus. Lymph node metastases tended to have an orderly spreading pattern in relation to the tumor location, even though the lymph node metastasis varied widely from the lower neck to the upper abdomen. The nodes along the right recurrent nerve and the paracardiac nodes were most frequently found to be positive for metastasis. In contrast, no metastasis was found in the internal jugular nodes, the pretracheal nodes, the common hepatic nodes, or the splenic nodes. Patients with carcinoma in the upper thoracic esophagus rarely had metastasis in the abdominal nodes, while those with carcinoma in the lower thoracic esophagus rarely had metastasis in the cervical nodes. Thus, surgical extirpation of the lymph nodes during 3-field dissection is effective not only to determine the correct tumor staging for the planning of adequate adjuvant therapies postoperatively, but also to produce a guideline for prospective lymphadenectomy for esophageal carcinomas.
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References
Sato T, Sakamoto K (1992) Illustrations and photographs of surgical esophageal anatomy specially prepared for lymph node dissection. In: Sato T, Iizuka T (eds) Color atlas of surgical anatomy for esophageal cancer. Springer, Berlin Heidelberg New York, pp 25–90
Kakegawa T, Shima I, Yamana H, Fujita H, Shirozu G, Minami T (1989) Prophylactic management based on the recurrence pattern following curative operation for thoracic esophageal cancer (in Japanese). Shyokaki Geka (Gastroenterol Surg) 12:155–162
Fujita H (1984) The mode of recurrence of esophageal cancer after surgical treatment — autopsy study (in Japanese with English abstract). Nippon Geka Gakkai Zasshi (J Jpn Surg Soc) 85:17–28
Sannohe Y, Hiratsuka R, Doki K (1981) Lymph node metastasis in cancer of the thoracic esophagus. Am J Surg 141:216–218
Akiyama H, Tsurumaru M, Ono Y, Udagawa H, Kajiyama Y (1992) Background of lymph node dissection for squamous cell carcinoma of the esophagus. In: Sato T, Iizuka T (eds) Color atlas of surgical anatomy for esophageal cancer. Springer, Berlin Heidelberg New York, pp 9–24
Kakegawa T, Fujita H, Yamana H (1992) Illustration of surgery for carcinoma in the thoracic esophagus. In: Sato T, Iizuka T (eds) Color atlas of surgical anatomy for esophageal cancer. Springer, Berlin Heidelberg New York, pp 91–116
International Union Against Cancer (1987) Oesophagus (ICD-0150) In: Hermanek P, Sobin LH (eds) TNM classification of malignant tumours. Springer, Berlin Heidelberg New York, pp 40–42
Isono K, Sato H, Nakayama K (1991) Results of a nationwide study on the three-field lymph node dissection of esophageal cancer. Oncology 48:411–420
Peracchia A, Ruol A, Bardini R, Segalin A, Castoro M, Asolati M (1992) Lymph node dissection for cancer of the thoracic esophagus: how extended should it be? Analysis of personal data and review of the literature. Diseases of the Esophagus 5:69–79
Siewert JR, Roder JD (1992) Lymphadenectomy in esophageal cancer surgery. Dis esophagus 5:91–97
Desai PB, Deshpande RK, Patil PK, Mistry RC (1992) Radical lymphadenectomy in esophageal cancer: does it improve survival? Dis Esophagus 5:99–104
Fekete F, Gayat B, Panis Y (1992) Long-term results of transthoracic esophagectomy for squamous cell carcinoma: analysis of lymph node involvement in 236 Western patients. Dis Esophagus 5:105–110
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Sharma, S., Fujita, H., Yamana, H. et al. Patterns of lymph node metastasis in 3-field dissection for carcinoma in the thoracic esophagus. Surg Today 24, 410–414 (1994). https://doi.org/10.1007/BF01427033
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DOI: https://doi.org/10.1007/BF01427033