The pattern and prevalence of lymphatic spread in thoracic oesophageal squamous cell carcinoma

Chen, Junqiang; Liu, Suoyan; Pan, Jianji; Xiao, Zheng; Zhu, Kunshou; Zhu, Ji; Xiao, Jing; Ying, Mingang

doi:10.1016/j.ejcts.2009.03.056

Cited by 89 publications

(80 citation statements)

References 15 publications

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“…The recurrent laryngeal nerve lymph node (RLNLN) is the most common metastatic site in ESCC, and the rates of RLNLN metastases in upper thoracic ESCC are even as high as 43.3% (7,8). The RLNLN metastases are considered as independent predictors of cervical lymph node metastases (LNM) (9)(10)(11). In addition, some scholars believe that regular RLNLN dissection is necessary for accurate staging and radical resection, particularly for middle and upper thoracic esophageal carcinomas (12).…”

Section: Original Articlementioning

confidence: 99%

“…Age, sex, the time of swallowing dysfunction, smoking history, carcinoembryonic antigen (CEA), cyfra21-1, history of other tumor, macroscopic tumor type, T stage, tumor differentiation, lymphovascular invasion (LVI), tumor length and tumor location were chosen as potential factors predictive of RLNLN metastases in ESCC patients who underwent thoracic esophagectomy with common bilateral RLNLN dissection based on previous studies of risk factors for esophageal cancer LNM (11,18,19 …”

Section: Risk Factorsmentioning

confidence: 99%

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Recurrent laryngeal nerve lymph node dissection may not be suitable for all early stage esophageal squamous cell carcinoma patients: an 8-year experience

Lin

Chen

et al. 2016

J. Thorac. Dis.

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Background: Recurrent laryngeal nerve (RLN) injury is one of the most frequent postoperative complications of esophageal squamous cell carcinoma (ESCC) radical resection. This study aims to develop a novel scoring system to predict recurrent laryngeal nerve lymph node (RLNLN) metastases in early ESCC and explore the indications for precise RLN lymphadenectomy. Results: A total of 311 cases selected from 1,466 ESCC patients were divided into the dissection group and the control group. Age, tumor length, macroscopic tumor type, T stage, tumor location and tumor differentiation were independent predictors of RLNLN metastases. The weighted scoring system included age (+2 for <56 years), tumor length (+2 for over 4.45 cm), tumor location (+4 for upper thoracic, +2 for mid-thoracic) and macroscopic tumor type (+1 for advanced type). The total number of points estimated the probability of RLNLN metastases [low-risk (0-2 point), 0%; moderate-risk (3-4 points), 9.8%; and highrisk (>4 points), 43.4%]. Besides, the dissection group had more complications and similar survival rate when compared with the control group.Conclusions: We developed a novel scoring system that accurately estimated the risk of RLNLN metastases in early ESCC patients. RLN lymphadenectomy may be safely omitted for the patients in the low-risk subgroup.

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Section: Original Articlementioning

confidence: 99%

Section: Risk Factorsmentioning

confidence: 99%

Recurrent laryngeal nerve lymph node dissection may not be suitable for all early stage esophageal squamous cell carcinoma patients: an 8-year experience

Lin

Chen

et al. 2016

J. Thorac. Dis.

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“…Most studies report that the neck and upper mediastinum are the regions most commonly affected by nodal metastasis in patients with upper ec [11][12][13] . The present study …”

Section: Discussionmentioning

confidence: 99%

Computed Tomography–Based Distribution of Involved Lymph Nodes in Patients with Upper Esophageal Cancer

Liu

et al. 2015

Current Oncology

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“…For squamous cell carcinoma, there are a few large retrospective and prospective cohort studies, that describe the distribution pattern of lymph node metastases (3,9,11,13,27). Most patients in these studies have T3 cancers and almost 60% has positive lymph nodes.…”

Section: Squamous Cell Carcinomamentioning

confidence: 99%

“…The distribution pattern of lymph node metastases of esophageal cancer is unpredictable. Distribution of lymph node metastases may depend on tumor characteristics such as tumor location, histology, T-stage and the use of neoadjuvant therapy (9)(10)(11)(12)(13)(14). The surgical strategy should depend on the distribution pattern of nodal metastases but there is no worldwide consensus on the extent of lymphadenectomy.…”

Section: Introductionmentioning

confidence: 99%

The extent of lymphadenectomy in esophageal resection for cancer should be standardized

et al. 2017

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The incidence of esophageal cancer increases, with approximately 482,000 patients diagnosed with esophageal cancer each year. Despite the growing incidence of esophageal carcinoma, the extent of the lymphadenectomy is still under discussion. Lymph node status is an important prognostic parameter in esophageal cancer and an independent predictor of survival. Surgical strategy depends on the distribution pattern of nodal metastases but consensus on the extent of lymphadenectomy differs worldwide. For squamous cell cancer, Japanese surgeons have standardized the 2-or 3-field lymphadenectomy according to the location of the tumor. For adenocarcinoma, in the Western World accounting for 85% of all esophageal cancers, the type of lymphadenectomy to perform is not clear. Moreover, the use of neoadjuvant therapy may influence the mediastinal lymph nodes and the significance of the lymphadenectomy for survival. These aspects have challenged the traditional policy concerning lymphadenectomy, at least in the Western World. Furthermore, an extensive lymphadenectomy may improve survival but, on the other hand, may cause significant more morbidity. An overview of the literature on the extent of lymphadenectomy for esophageal cancer with respect to the supposed lymph node distribution patterns for squamous cell carcinoma and adenocarcinoma, the different lymph node classification systems, the commonly used surgical techniques and outcomes, and the proposal of observational cohort study to standardize the type of lymphadenectomy according to the type of tumor, location and use of neoadjuvant therapy will be provided.

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The pattern and prevalence of lymphatic spread in thoracic oesophageal squamous cell carcinoma

Cited by 89 publications

References 15 publications

Recurrent laryngeal nerve lymph node dissection may not be suitable for all early stage esophageal squamous cell carcinoma patients: an 8-year experience

Recurrent laryngeal nerve lymph node dissection may not be suitable for all early stage esophageal squamous cell carcinoma patients: an 8-year experience

Computed Tomography–Based Distribution of Involved Lymph Nodes in Patients with Upper Esophageal Cancer

The extent of lymphadenectomy in esophageal resection for cancer should be standardized

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