Abdominal Lymph Node Metastasis in Patients with Mid Thoracic Esophageal Squamous Cell Carcinoma |
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Authors: | Gang Chen Zhou Wang Xiang-yan Liu Ming-yue Zhang and Fan-ying Liu |
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Institution: | (1) Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, 250021, People’s Republic of China |
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Abstract: | Background There are few reports about abdominal lymph node metastasis of mid thoracic esophageal carcinoma. This study was designed
to explore the pattern of abdominal lymph node metastasis in patients with mid thoracic esophageal squamous cell carcinoma
and to evaluate the prognostic factors.
Methods The complete data of 368 patients with mid thoracic esophageal squamous cell carcinoma, who underwent modified Ivor-Lewis
esophagectomy with two-field lymphadenectomy from January 1998 to January 2003, were reviewed. Survival rate was calculated
by Kaplan-Meier method. Cox regression analysis was performed to identify risk prognostic factors.
Results Abdominal lymph node metastasis occurred in 58 (15.8%) patients: 34.5% (20/58) of them were stage T1 and T2. Skipping abdominal
node metastasis was recognized in 13.8% (8/58) patients: all were stage T1 and T2. The overall 5-year survival rate of patients
with abdominal lymph node metastasis (10.3%) was lower than that of those with thoracic node metastasis (18.3%). The prognosis
of patients with distant abdominal lymph node metastasis was poor, and no one could survive more than 5 years. Cox regression
analysis showed that five or more positive nodes and distant abdominal node metastasis were independent risk factors of patients
with abdominal lymph node metastasis.
Conclusions Abdominal lymph node metastasis in patients with mid thoracic esophageal squamous cell carcinoma occurred frequently, and
the surgery favorable for extensive abdominal lymph node dissection should be selected. The prognosis of patients with abdominal
lymph node metastasis was poor, especially those with more positive nodes and distant abdominal node metastasis. |
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