J.Jpn. Surg. Soc.. 98(9): 747-750, 1997

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Feature topic

RATIONAL LYMPHADENECTOMY IN PATIENTS WITH CERVICAL NODES METASTASIS FOR CARCINOMA OF THE LOWER THIRD ESOPHAGUS

Prognostic value of removing cervical nodes in patients with carcinoma of the lower third esophagus is extremely controversial. Of 93 patients with curative esophagectomy via trans-thoracic approach, cervical nodes were involved in five patients (13％), upper mediastinal nodes in 12 patients (30％), and para-aortic nodes in only one patients (3％) for 40 patients whose proximal part of the tumor invading the mid-esophagus from below. Of the remaining 53 patients with tumor extent confined to the lower third esophagus, cervical nodes were involved in only one patients (2％), upper mediastinal nodes in five patients (9％), and paraaortic nodes in six patients (11％). Three of the five patients with cervical metastasis whose proximal part of the tumor invading the mid-esophagus survived for at Ieast 22months or more following three-field Iymphadenectomy. Removing the cerevical nodes in patients with carcinoma of the lower third esophagus may have some role to improve the survival if the tumor invades the mid-esophagus from below.

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