J.Jpn. Surg. Soc.. 98(9): 727-732, 1997

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Feature topic

LYMPH NODE DISSECTION FOR T1 ESOPHAGEAL CANCER

Proper mucosal cancer of esophagus of esophageal has no lymph node metastasis, and lymph node metastasis occurs when the tumor invades to muscularis mucosa. Submucosal cancer of esophagus has lymph node metastasis in the rate of 44.4％ (40/90). The incidence and number of metastatic lymph node increase with the depth of invasion.
Lymph node metastasis of esophageal cancer spreads widely to cervix, mediastinum and abdomen. It’s same in submucosal cancer and first metastasis occurs also appears at everywhere from cervix to abdomen. There are high rate of lymph node metastasis in 101L, 105, 106rR, 106rL, 108, 110, 1, 2, 3, 7 lymph nodes. The cancer in upper thoracic esophagus has high rate of lymph node metastasis in cervix and upper mediastinum and lymph node metastasis of lower thoracic esophageal cancer is liable to appear in lower mediastinum and abdomen. Then the cancer in middle thoracic esophagus should be performed the lymph node dissection in cervix, mediastinum and abdomen, especially 101, 102m, 104, 105, 106r, 106t, 107, 108, 110, 1, 2, 3, 7 lyniph nodes.
On the other hand, cancers Iimited to proper mucosal layer should be treated with endoscopic mucosal resection. And its same as in the greater part of cancers invaded to muscularis mucosa and shallow layer of esophageal submucosa.
The 5 year survival rate of T1 cancers of esophagus is 85.6％, which were performed surgical treatment.

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