Abstract
A series of 335 patients with squamous cell carcinoma of the thoracic esophagus undergoing resection and reconstruction via a right thoracotomy and laparotomy with cervical anastomosis between 1973 and 1990, were reviewed. Prior to 1982, the removal of lymph nodes was limited to the nodes in the mediastinum below the tracheal bifurcation and upper abdomen (142 patients). Nodal metastases were found in 89 of these patients at operation. The upper abdominal nodes were the most frequent sites of metastasis (47.2%). None of the 38 patients with positive nodes sampled from the neck and superior mediastinum survived for more than 45 months. In the 50 patients with recurrences, 30 were in the neck and/or superior mediastinum. During or after 1983, the superior mediastinal nodes, particularly the bilateral recurrent nerve nodal chains, were routinely removed (193 patients). Nodal metastasis was proven in 131 of the 193 patients, in whom 87 (45.1%) had metastasis in the neck and superior mediastinum. Eleven of these 87 patients survived for 45 months or more. In the 61 patients with recurrences, 20 were in the neck and/or superior mediastinum. These data suggest that recurrent nerve nodal chains should be removed to improve survival in patients with esophageal carcinoma.
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Tilanus HW, Hop WJ, Langenhorst BM, Lanschot JB (1993) Esophagectomy with or without thoracotomy. Is there any difference? J Thorac Cardiovasc Surg 105:898–903
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
Desai PB, Deshpande RK, Patil PK, Mistry RC (1992) Radical lymphadenectomy in esophageal cancer: does it improve survival? Dis Esophag 5:99–104
Baba M, Kuroshima K, Tanabe G, Natsugoe S, Yoshinaka H, Kawasaki Y, Kiire A, Mure H, Fukumoto T, Matsuno M, Aikou T, Shimazu H, Nishi M; (1987) Lymph flow and lymph node metastasis of thoracic esophageal cancer (in Japanese). Nippon syokaki Geka Gakkai Zasshi (Jpn J Gastroenterol Surg) 20:2269–2277
Akiyama H, Tsurumaru M, Kawamura T, Ono Y (1981) Principles of surgical treatment for carcinoma of the esophagus. Ann Surg 194:438–446
Hermanek P, Sobin LH. comps. (1987) International Union Against Cancer (UICC) TNM classification of malignant tumors, 4th edn. Springer, Berlin Heidelberg New York
Sato T, Iizuka T. comps. (1992) Color Atlas of Surgical Anatomy for Esophageal Cancer. Springer, Berlin Heidelberg New York, pp 25–90
Baba M, Aikou T, Yoshinaka H, Natsugoe S, Fukumoto T, Shimazu H, Akazawa K (1993) Long-term results of subtotal esophagectomy with three-field lymphadenectomy for carcinoma of the thoracic esophagus. Ann Surg 219:310–316
Haagensen CD (1972) The lymphatics in cancer. WB Saunders, Philadelphia, pp 245–249
Baba M, Yoshinaka H, Tanabe G, Kusano C, Fukumoto T, Aikou T, Shimazu H (1988) Clinicopathological studies on the recurrence of esophageal squamous cell cancer — with a special reference to the mode of recurrence and operative procedures — (in Japanese with English abstract). Nippon Geka Gakkai Zasshi (J Jpn Surg Soc) 89:1769–1779
Skinner DB (1983) En bloc resection for neoplasms of the esophagus and cardia. J Thorac Cardiovasc Surg 85:59–71
Siewert JR, Roder JD (1992) Lymphadenectomy in esophageal cancer surgery. Dis Esophag 5:91–97
Kato H, Watanabe H, Tachimori Y, Iizuka T (1991) Evaluation of neck lymph node dissection for thoracic esophageal carcinoma. Ann Thorac Surg 51:931–935
Lerut T, Leyn PD, Coosemans W, Raemdonck DV, Scheys I, Saffre EL (1992) Surgical strategies in esophageal carcinoma with emphasis on radical lymphadenectomy. Ann Surg 216:583–590
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Baba, M., Natsugoe, S., Kusano, C. et al. Lymph node metastasis and the recurrence of esophageal carcinoma with emphasis on lymphadenectomy in the neck and superior mediastinum. Surg Today 25, 125–130 (1995). https://doi.org/10.1007/BF00311083
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DOI: https://doi.org/10.1007/BF00311083