J.Jpn. Surg. Soc.. 98(9): 742-746, 1997
Feature topic
REASONABLE LYMPH NODE DISSECTION FOR T2 OR T3 MIDTHORACIC ESOPHAGEAL CANCER WITH CERVICAL LYMPH NODE METASTASIS
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Second Department of Surgery, Chiba University School of Medicine, Chiba, Japan Yoshio Koide, Shinichi Okazumi, Hideaki Shimada, Hisahiro Matsubara, Yukimasa Miyazawa, Miwako Arima, Akitoshi Komori, Toru Fukunaga, Kaichi Isono |
Metastasis to cervical lymph node was obtained in 27.4％ (29/106) of patients with T2 or T3 midthoracic esohageal cancer. Within 29 patients, metastasis in cervical node only, in two fields and in three fields occupied 17.2％, 41.4％ and 41.4％, respectively. And according to the histologic examination of dissected lymph nodes, metastatic sites spreaded from neck to perigastric region.
Five-year survival rate of 23 patients receiving curative operation was 33.0％, and that of 13 patients excluding 3-field metastasis was 51.9％. But the main sites of nodal recurrence were cervical or superior mediastinal nodes along the bilateral recurrent laryngeal nerves, and the rate of nodal recurrence was 47. 8％.
These results of actual state of Iymph node metastasis and prognostic benefit of aggressive dissection suggest that 3-field lymph node dissection is mandatory for T2 or T3 midthoracic esophageal cancer with cervical lylnph node metastasis. And we should endeavor to upgrade the precise dissection in order to decrease the nodal recurrnce.
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