Lymph Node Metastasis in Esophageal Cancer; With Special Reference to Upper Mediastinum and Measures for Its Treatment

Esophageal Cancer: Lymphadenectomy Based on the Lymph Node Compartment Classification

“…Orringer [7] has emphasized that lymph node dissection did not offer improved survival to patients with esophageal carci noma and has performed transhiatal esophagectomy without lymph node dissection [7], On the other hand, Skinner et al [8] and Siewert et al [9] have considered that extended radical lymph node dissection can improve survival and have performed en-bloc esophagectomy with mediastinectomy in which the lower mediastinal lymph nodes are aggressively resected together with mediastinal tissue. In contrast, dissection for the cervical and upper mediastinal lymph nodes has been widely adopted in Japan, since Kinoshita et al [10] and Sannohe et al [11] found frequent metastasis in the right recurrent nerve nodes and in the cervical nodes.…”

Topographical anatomy of the bronchomediastinal lymph vessels: Their relationships and formation of the collecting trunks.

“…However, as the highest right mediastinal nodes (KINOSHITA et al, 1976), situated in juxtaposition with the origin of the right recurrent laryngeal nerve, were located very close to the superior portion of the right paratracheal chain, the paratracheal node chain was intimately related to the recurrent nerve chain.…”

“…NARUKE et al (1978) suggested that, in lung cancer, the metastatic invasion of the subcarinal nodes (herein termed infracarinal nodes) has a significant influence on the prognosis. KINOSHITA et al (1976) reported that the prognosis of an esophageal cancer patient is closely related to the metastatic invasion of the nodes, "the highest right mediastinal nodes" which are situated close to the origin of the right recurrent laryngeal nerve. Consistent with these clinically observed facts, the present study revealed that the inf racarinal nodes were closely connected with the upper portion of the right paratracheal chain via numerous ascending lymph vessels (Figs.…”

History of the Japanese Classification of Esophageal Cancer

“…Thus, the principle was established that the macroscopic classification Iwao Takagi and Tamaki Kajitani of the Cancer Institute Hospital first reported the high incidence of metastasis in the right recurrent nerve nodes in 1976 [26]. Yasuo Sannohe of Fukuoka University reported the high incidence of metastasis in the supraclavicular lymph nodes even in cases of resectable esophageal cancer in 1981 [27].…”