Lymphadenectomy For Esophageal Carcinoma Research Articles

PS01.154: COULD POSITIVE RECURRENT LARYNGEAL NERVE LYMPH NODES BE AN INDICATOR TO CERVICAL LYMPHADENECTOMY IN THORACIC ESOPHAGEAL SQUAMOUS CELL CARCINOMA PATIENTS?

Abstract Background As three-field lymphadenectomy for esophageal carcinoma is one of the most invasive operations, this procedure should be selected only when strictly indicated.Unfortunately, there are no useful criteria for it at present. In this study, we retrospectively examine the correlation between recurrent laryngeal nerve lymph nodes(RLN) and cervical lymph nodes(CLN) metastasis. Methods We reviewed the outcomes between recurrent laryngeal nerve lymph nodes(RLN) and cervical lymph nodes(CLN) metastasis for patients with squamous cell carcinoma of the thoracic esophagus(ESCC) from our institution. One hundred and thirty-five patients who underwent curative esophagectomy with three-field dissection for ESCC were enrolled in this study. The relationship between RLN involvement and CLN metastasis was examined. Results One hundred and thirty-five patients met the inclusion criteria. The overall rate of CLN metastasis was 36.3% for all patients and was 46.9%, 25.6%, and 6.7% for patients with upper, middle, and lower thoracic esophageal tumors, respectively (P = 0.003). The overall rate of RLN metastasis was 53.3%. The rate of CLN metastasis for all patients with or without CLN involvement were 44.4% and27.0% (P = 0.036.The positive predictive value, negative predictive value, sensitivity, and specificity of RLN as the sentinel nodes to predict the CLN metastasis were 65.3%,53.5%,44.4% and 73.0%, respectively. Conclusion We concluded that the recurrent nerve nodal alone should not be regarded as the criteria for cervical lymph nodes dissection. Disclosure All authors have declared no conflicts of interest.

Lymphatic spreading and lymphadenectomy for esophageal carcinoma.

Esophageal carcinoma (EC) is a highly lethal malignancy with a poor prognosis. One of the most important prognostic factors in EC is lymph node status. Therefore, lymphadenectomy has been recognized as a key that influences the outcome of surgical treatment for EC. However, the lymphatic drainage system of the esophagus, including an abundant lymph-capillary network in the lamina propria and muscularis mucosa, is very complex with cervical, mediastinal and celiac node spreading. The extent of lymphadenectomy for EC has always been controversial because of the very complex pattern of lymph node spreading. In this article, published literature regarding lymphatic spreading was reviewed and the current lymphadenectomy trends for EC are discussed.