Pattern of lymph node metastasis in 177 thoracic esophageal cancer patients_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

DAILei , RENZixue , ZHANGAnqing ,  ZHANGRongxin

Department of Thoracic Surgery, West Branch of Anhui Provincial Hospital, Anhui Provincial Tumour Hospital, Hefei, 230088, P.R.China;

Corresponding?author：

ZHANGRongxin, Email: zrx13855219010@126.com

Keywords：

Esophageal tumor; lymphatic metastasis; surgical procedures, operative; lymph node dissection

DOI：

10.7507/1007-4848.201606002

Video：

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Objective This study analyzed the pattern and influence factors of lymph node metastasis in thoracic esophageal cancer to provide a reference for the lymph node dissection for esophageal cancer. Methods Clinical data of 177 patients with thoracic esophageal cancer receiving the lymph node dissection in our department from 2015 to 2016 were retrospectively analyzed. There were 125 males and 52 females with a median age of 64 years, ranging from 18 to 86 years. We excluded cervical esophageal cancer and adenocarcinoma of the esophagogastric junction and analyzed the relationship between lymph node metastasis and tumor pathological type, depth of invasion, degree of differentiation and length. Results Of the 177 patients, 76 (42.9%) were found to have lymph node metastasis. In the 4 977 dissected lymph nodes, metastasis was identfied in 361 (7.3%) lymph nodes. The rate of lymph node metastasis in thoracic esophageal carcinoma was not related to the location and length of the tumor (P>0.05), but related to the depth of invasion and the degree of differentiation (P<0.05). Conclusion Lymph node metastasis is prone to present in the early stage of thoracic esophageal cancer. According to the characteristics of lymph node metastasis in thoracic esophageal carcinoma, we need have a standardized, systematic and focused lymph node dissection.

Citation： DAILei, RENZixue, ZHANGAnqing, ZHANGRongxin. Pattern of lymph node metastasis in 177 thoracic esophageal cancer patients. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(2): 122-126. doi: 10.7507/1007-4848.201606002 Copy

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2.	Takubo K, Makuuchi H, Fujita H, et al. Japanese classification of esophageal cancer, tenth edition: part Ⅰ. Esophagus, 2009, 6(1): 1-25.
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6.	秦建軍, 李印. 日本 2015 食管癌診治指南解讀: 胸段食管癌的外科治療. 中國胸心血管外科臨床雜志, 2016, 23(2): 101-103.
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9.	Tachimori Y, Ozawa S, Numasaki H, et al. Efficacy of lymph node dissection by node zones according to tumor location for esophageal squamous cell carcinoma. Esophagus, 2016, 13: 1-7.
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14.	Ye T, Sun Y, Zhang Y, et al. Three-field or two-field resection for thoracic esophageal cancer: a meta-analysis. Ann Thorac Surg, 2013, 96(6): 1933-1941.
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16.	張穎穎, 王玉, 張航, 等. 三野與二野淋巴結清掃術治療食管癌療效及安全性的系統評價與 Meta 分析. 中國胸心血管外科臨床雜志, 2016, 23(8): 814-821.
17.	任自學, 張榮新, 王圣應, 等. 選擇性三野淋巴結清掃在胸中、上段食管癌中的應用. 臨床醫學與護理研究, 2014, 13(3): 40-41.
18.	柳常青, 解明然, 郭明發, 等. 微創 Ivor-Lewis 食管癌根治術圍手術期結果分析. 中華腫瘤防治雜志, 2014, 21(6): 454-457.
19.	陶開義, 陳奇勛, 趙強, 等. 胸腹腔鏡與傳統 Ivor-Lewis 手術對早中期食管癌患者術后生活質量的影響. 中國腫瘤, 2016, 25(3): 226-232.
20.	Bencini L, Moraldi L, Bartolini I, et al. Esophageal surgery in minimally invasive era. World J Gastrointest Surg, 2016, 8(1): 52-64.

1. ?趙海龍, 薛繼軍, 鄭鳳長, 等. 食管癌術后生存五年以上患者復發轉移的相關因素分析. 中國胸心血管外科臨床雜志, 2016, 23(6): 546-549.
2. Takubo K, Makuuchi H, Fujita H, et al. Japanese classification of esophageal cancer, tenth edition: part Ⅰ. Esophagus, 2009, 6(1): 1-25.
3. Lee HJ, Lee H, Park JC, et al. Treatment strategy after endoscopic resection of superficial esophageal squamous cell carcinoma: A single institution experience. Gut Liver, 2015, 9(6): 714-719.
4. Park JS, Youn YH, Park JJ, et al. Clinical outcomes of endoscopic submucosal dissection for superficial esophageal squamous neoplasms. Clin Endosc, 2016, 49(2): 168-175.
5. 楊軍, 陳詩嫻, 呂必宏, 等. 胸段食管癌淋巴結轉移特征及對預后的影響. 江蘇醫藥, 2016, 42(13): 1474-1477.
6. 秦建軍, 李印. 日本 2015 食管癌診治指南解讀: 胸段食管癌的外科治療. 中國胸心血管外科臨床雜志, 2016, 23(2): 101-103.
7. Liebermann-Meffert D. Anatomical basis for the approach and extent of surgical treatment of esophageal cancer. Dis Esophagus, 2001, 14(2): 81-84.
8. 王軍, 韓春, 祝淑釵, 等. 胸段食管癌淋巴結轉移規律及其影響因素. 中國腫瘤臨床, 2010, 37(2): 90-93.
9. Tachimori Y, Ozawa S, Numasaki H, et al. Efficacy of lymph node dissection by node zones according to tumor location for esophageal squamous cell carcinoma. Esophagus, 2016, 13: 1-7.
10. 崔岳, 謝天鵬, 楊曉軍, 等. 胸段食管癌上縱隔淋巴結轉移規律的臨床分析. 中國胸心血管外科臨床雜志, 2015, 22(11): 1026-1030.
11. 中國抗癌協會食管癌專業委員會. 食管癌規范化診治指南. 北京: 中國協和醫科大學出版社, 2011. 24-61.
12. 陳躍軍, 鄒求益, 朱廣, 等. 胸段食管癌淋巴結轉移特點的臨床研究. 中華胃腸外科雜志, 2013, 16(9): 835-837.
13. Lin J, Kang M, Chen S, et al. Feasibility and strategy for left tracheobronchial lymph node dissection in thoracolaparoscopic esophageal cancer surgery. Thorac Cancer, 2016, 7(2): 199-206.
14. Ye T, Sun Y, Zhang Y, et al. Three-field or two-field resection for thoracic esophageal cancer: a meta-analysis. Ann Thorac Surg, 2013, 96(6): 1933-1941.
15. Ma GW, Situ DR, Ma QL, et al. Three-field vs two-field lymph node dissection for esophageal cancer: a meta-analysis. World J Gastroenterol, 2014, 20(47): 18022-18030.
16. 張穎穎, 王玉, 張航, 等. 三野與二野淋巴結清掃術治療食管癌療效及安全性的系統評價與 Meta 分析. 中國胸心血管外科臨床雜志, 2016, 23(8): 814-821.
17. 任自學, 張榮新, 王圣應, 等. 選擇性三野淋巴結清掃在胸中、上段食管癌中的應用. 臨床醫學與護理研究, 2014, 13(3): 40-41.
18. 柳常青, 解明然, 郭明發, 等. 微創 Ivor-Lewis 食管癌根治術圍手術期結果分析. 中華腫瘤防治雜志, 2014, 21(6): 454-457.
19. 陶開義, 陳奇勛, 趙強, 等. 胸腹腔鏡與傳統 Ivor-Lewis 手術對早中期食管癌患者術后生活質量的影響. 中國腫瘤, 2016, 25(3): 226-232.
20. Bencini L, Moraldi L, Bartolini I, et al. Esophageal surgery in minimally invasive era. World J Gastrointest Surg, 2016, 8(1): 52-64.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Pattern of lymph node metastasis in 177 thoracic esophageal cancer patients

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