Clinical analysis of the predictive value of recurrent laryngeal nerve lymph nodes status for supraclavicular lymph node metastasis in esophageal squamous cell carcinoma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 ZHENG Xiaodong , ZHANG Weimin , HOU Jianbin

Department of Thoracic Surgery, Anyang Tumor Hospital, Anyang, 455000, Henan, P.R.China;

Corresponding?author：

ZHENG Xiaodong, Email: 18898768@qq.com

Keywords：

Esophageal cancer; three-field lymph node dissection; recurrent laryngeal nerve lymph node; supraclavicular lymph node

DOI：

10.7507/1007-4848.201906011

Video：

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Objective To investigate the predictive value of recurrent laryngeal nerve lymph nodes (RLN) status for supraclavicular lymph node (SLN) metastasis in esophageal squamous cell carcinoma.Methods We retrospectively analyzed the clinical data of 83 patients with esophageal squamous cell carcinoma who underwent McKeown three-field lymphadenectomy from January 2017 to April 2018 in our hospital, including 53 males and 30 females with an average age of 64.07±7.05 years.Results The SLN metastasis rate of the patients was 24.1%. The rate in the thoracic and abdominal metastases positive (N_1-3) group and negative (N₀) group was 37.8% and 13.0%, respectively, with a statistical difference (P<0.05). The rate of SLN metastasis was significantly different between the RLN metastasis positive (RLN+) and negative (RLN–) groups (39.1% vs. 18.3%, P<0.05). One side of RLN metastasis could lead to SLN metastasis on the opposite side. No correlation between the SLN metastasis and age, gender, location, differentiation degree, maximum tumor diameter, T-staging or histologic type was observed (P>0.05). Multivariate analysis showed that lymph node metastasis in chest or abdomen was an independent predictor of SLN metastasis.Conclusion RLN+ is not the independent predictor for SLN metastasis. SLN should be dissected in N_1-3 patients with esophageal squamous cell carcinoma without considering tumor location and T-staging. Bilateral SLN dissection should be recommended even if RLN metastasis is only unilateral.

Citation： ZHENG Xiaodong, ZHANG Weimin, HOU Jianbin. Clinical analysis of the predictive value of recurrent laryngeal nerve lymph nodes status for supraclavicular lymph node metastasis in esophageal squamous cell carcinoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(3): 297-302. doi: 10.7507/1007-4848.201906011 Copy

1.	Kato H, Watanabe H, Tachimori Y, et al. Evaluation of neck lymph node dissection for thoracic esophageal carcinoma. Ann Thorac Surg, 1991, 51(6): 931-935.
2.	Altorki N, Kent M, Ferrara C, et al. Three-field lymph node dissection for squamous cell and adenocarcinoma of the esophagus. Ann Surg, 2002, 236(2): 177-183.
3.	Fujita H, Kakegawa T, Yamana H, et al. Mortality and morbidity rates, postoperative course, quality of life, and prognosis after extended radical lymphadenectomy for esophageal cancer. Comparison of three-field lymphadenectomy with two-field lymphadenectomy. Ann Surg, 1995, 222(5): 654-662.
4.	李志剛. 胸腔鏡下雙側頸部喉返神經旁(101 組)淋巴結清掃及相關解剖標志. 中華胸部外科電子雜志, 2015, 2(2): 136.
5.	Shim YM, Kim HK, Kim K. Comparison of survival and recurrence pattern between two-field and three-field lymph node dissections for upper thoracic esophageal squamous cell carcinoma. J Thorac Oncol, 2010, 5(5): 707-712.
6.	Taniyama Y, Nakamura T, Mitamura A, et al. A strategy for supraclavicular lymph node dissection using recurrent laryngeal nerve lymph node status in thoracic esophageal squamous cell carcinoma. Ann Thorac Surg, 2013, 95(6): 1930-1937.
7.	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.
8.	Li H, Fang W, Yu Z, et al. Chinese expert consensus on mediastinal lymph node dissection in esophagectomy for esophageal cancer (2017 edition). J Thorac Dis, 2018, 10(4): 2481-2489.
9.	Davies AR, Sandhu H, Pillai A, et al. Surgical resection strategy and the influence of radicality on outcomes in oesophageal cancer. Br J Surg, 2014, 101(5): 511-517.
10.	Ueda Y, Shiozaki A, Itoi H, et al. Intraoperative pathological investigation of recurrent nerve nodal metastasis can guide the decision whether to perform cervical lymph node dissection in thoracic esophageal cancer. Oncol Rep, 2006, 16(5): 1061-1066.
11.	翁軍玲, 田輝, 李魯波. 食管癌患者胸內喉返神經旁淋巴結轉移與頸部淋巴結的關聯性. 世界華人消化雜志, 2016, 24(16): 2537-2542.
12.	Tachimori Y, Nagai Y, Kanamori N, et al. Pattern of lymph node metastases of esophageal squamous cell carcinoma based on the anatomical lymphatic drainage system. Dis Esophagus, 2011, 24(1): 33-38.
13.	Shang QX, Chen LQ, Hu WP, et al. Three-field lymph node dissection in treating the esophageal cancer. J Thorac Dis, 2016, 8(10): E1136-E1149.
14.	段孝鳳, 高曉旭, 顧憲文. 序貫三切口及選擇性淋巴結清掃治療食管癌1162例臨床效果分析. 腫瘤研究與臨床, 2014, 26(6): 381-385.
15.	沈國義, 張文山, 張奕, 等. 術中胸內喉返神經旁淋巴結冰凍在指導胸段食管鱗癌三野淋巴結清掃的意義. 福建醫科大學學報, 2017, 51(4): 240-244.
16.	朱德奇, 李春霖, 王忠民, 等. PT_1-3N₀M₀胸段食管鱗癌術后頸部淋巴結轉移危險因素分析. 中國實驗診斷學, 2019, 23(4): 623-625.
17.	Shao L, Ye T, Ma L, et al. Three-field versus two-field lymph node dissection for thoracic esophageal squamous cell carcinoma: a propensity score-matched comparison. J Thorac Dis, 2018, 10(5): 2924-2932.

1. Kato H, Watanabe H, Tachimori Y, et al. Evaluation of neck lymph node dissection for thoracic esophageal carcinoma. Ann Thorac Surg, 1991, 51(6): 931-935.
2. Altorki N, Kent M, Ferrara C, et al. Three-field lymph node dissection for squamous cell and adenocarcinoma of the esophagus. Ann Surg, 2002, 236(2): 177-183.
3. Fujita H, Kakegawa T, Yamana H, et al. Mortality and morbidity rates, postoperative course, quality of life, and prognosis after extended radical lymphadenectomy for esophageal cancer. Comparison of three-field lymphadenectomy with two-field lymphadenectomy. Ann Surg, 1995, 222(5): 654-662.
4. 李志剛. 胸腔鏡下雙側頸部喉返神經旁(101 組)淋巴結清掃及相關解剖標志. 中華胸部外科電子雜志, 2015, 2(2): 136.
5. Shim YM, Kim HK, Kim K. Comparison of survival and recurrence pattern between two-field and three-field lymph node dissections for upper thoracic esophageal squamous cell carcinoma. J Thorac Oncol, 2010, 5(5): 707-712.
6. Taniyama Y, Nakamura T, Mitamura A, et al. A strategy for supraclavicular lymph node dissection using recurrent laryngeal nerve lymph node status in thoracic esophageal squamous cell carcinoma. Ann Thorac Surg, 2013, 95(6): 1930-1937.
7. 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.
8. Li H, Fang W, Yu Z, et al. Chinese expert consensus on mediastinal lymph node dissection in esophagectomy for esophageal cancer (2017 edition). J Thorac Dis, 2018, 10(4): 2481-2489.
9. Davies AR, Sandhu H, Pillai A, et al. Surgical resection strategy and the influence of radicality on outcomes in oesophageal cancer. Br J Surg, 2014, 101(5): 511-517.
10. Ueda Y, Shiozaki A, Itoi H, et al. Intraoperative pathological investigation of recurrent nerve nodal metastasis can guide the decision whether to perform cervical lymph node dissection in thoracic esophageal cancer. Oncol Rep, 2006, 16(5): 1061-1066.
11. 翁軍玲, 田輝, 李魯波. 食管癌患者胸內喉返神經旁淋巴結轉移與頸部淋巴結的關聯性. 世界華人消化雜志, 2016, 24(16): 2537-2542.
12. Tachimori Y, Nagai Y, Kanamori N, et al. Pattern of lymph node metastases of esophageal squamous cell carcinoma based on the anatomical lymphatic drainage system. Dis Esophagus, 2011, 24(1): 33-38.
13. Shang QX, Chen LQ, Hu WP, et al. Three-field lymph node dissection in treating the esophageal cancer. J Thorac Dis, 2016, 8(10): E1136-E1149.
14. 段孝鳳, 高曉旭, 顧憲文. 序貫三切口及選擇性淋巴結清掃治療食管癌1162例臨床效果分析. 腫瘤研究與臨床, 2014, 26(6): 381-385.
15. 沈國義, 張文山, 張奕, 等. 術中胸內喉返神經旁淋巴結冰凍在指導胸段食管鱗癌三野淋巴結清掃的意義. 福建醫科大學學報, 2017, 51(4): 240-244.
16. 朱德奇, 李春霖, 王忠民, 等. PT_1-3N₀M₀胸段食管鱗癌術后頸部淋巴結轉移危險因素分析. 中國實驗診斷學, 2019, 23(4): 623-625.
17. Shao L, Ye T, Ma L, et al. Three-field versus two-field lymph node dissection for thoracic esophageal squamous cell carcinoma: a propensity score-matched comparison. J Thorac Dis, 2018, 10(5): 2924-2932.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical analysis of the predictive value of recurrent laryngeal nerve lymph nodes status for supraclavicular lymph node metastasis in esophageal squamous cell carcinoma

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