Abstract
BackgroundRecurrent laryngeal nerve (RLN) lymph node metastasis used to be shown a predictor for poor prognosis in esophageal squamous cell carcinoma. The purpose of this study was to evaluate the prognostic impact of RLN node metastasis and the number of metastatic lymph nodes in node-positive patients with squamous cell carcinoma of middle thoracic esophagus.MethodsA cohort of 235 patients who underwent curative surgery for squamous cell carcinoma of middle thoracic esophagus was investigated. The prognostic impact was evaluated by univariate and multivariate analyses.ResultsLymph node metastasis was found in 133 patients. Among them, 81 had metastatic RLN nodes, and 52 had at least one positive node but no RLN nodal involvement. The most significant difference in survival was detected between patients with metastatic lymph nodes below and above a cutoff value of six (P < 0.001). Multivariate analysis revealed that the number of metastatic lymph nodes was a significant factor associated with overall survival (P < 0.001), but RLN lymph node metastasis was not (P = 0.865).ConclusionsRLN Lymph node metastasis is not, but the number of metastatic nodes is a prognostic predictor in node-positive patients with squamous cell carcinoma of the middle thoracic esophagus.
Highlights
Recurrent laryngeal nerve (RLN) lymph node metastasis used to be shown a predictor for poor prognosis in esophageal squamous cell carcinoma
Recurrent laryngeal nerve (RLN) lymph node is located at the cervical base continuous to the upper mediastinum, which is one of the most common sites of lymph node metastasis in thoracic esophageal squamous cell carcinoma [1,2,3,4]
Some studies showed that the site of nodal involvement was not associated with the prognosis of thoracic esophageal squamous cell carcinoma, and the number of metastatic lymph nodes had a greater prognostic significance in thoracic esophageal squamous cell carcinoma [12,13,14]
Summary
Recurrent laryngeal nerve (RLN) lymph node metastasis used to be shown a predictor for poor prognosis in esophageal squamous cell carcinoma. The purpose of this study was to evaluate the prognostic impact of RLN node metastasis and the number of metastatic lymph nodes in node-positive patients with squamous cell carcinoma of middle thoracic esophagus. Some studies showed that the site of nodal involvement was not associated with the prognosis of thoracic esophageal squamous cell carcinoma, and the number of metastatic lymph nodes had a greater prognostic significance in thoracic esophageal squamous cell carcinoma [12,13,14] These results are contradictory to the findings mentioned above that RLN node metastasis is an unfavorable prognostic factor in thoracic esophageal squamous cell carcionoma. To evaluate the outcome of curative esophagectomy treatment, as well as the prognostic impacts of RLN node metastasis and the number of metastatic lymph nodes, in this study, we analyzed a cohort of patients with squamous cell carcinoma of the middle esophagus admitted in our institution
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