J.Jpn. Surg. Soc.. 83(9): 874-877, 1982

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Report on the annual meeting

THE INCIDENCE AND THE OPERATIVE MODALITY OF LYMPH NODES METASTASIS IN THE THORACIC ESOPHAGEAL CANCER

The lymph node metastasis was found in 71% of the total resected esophageal cancer cases. In cancer of the upper thoracic esophagus metastasis to tracheal lymph nodes and subcarinal lymph nodes occurred in 16% and 23% of cases respectively, to the mid-thoracic paraesophageal lymph nodes in 23% and to the left and right cardiac lymph nodes in 23% and 13% respectively. While a further increase in metastasis to intraabdominal lymph nodes was recognized in cancer of the mid-thoracic and lower thoracic esophagus, metastasis to tracheal and upper paraesophageal lymph nodes was seen in 9% and 4% of cases respectively in the lower thoracic esophageal cancer. Therefore, in cancer of the thoracic esophagus, all lymph nodes should be dissected systematically beginning from the upper thorax as far as the area around the common hepatic artery in the abdomen. Otherwise, metastasis to left supraclavicular region was found in 4-6% of cases in the thoracic esophageal cancer. In our series the recurrence of esophageal cancer was most frequently seen as metastatic recurrence in the neck and upper mediastinum in the curative resection cases. As a prophylactic measure the post-operative irradiation of the neck and upper mediastinum was performed. There was a clear difference in terms of the site of recurrence in patients who had curative resections.

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