Prognosis of patients with carcinoma of the thoracic esophagus, with special reference to the number of metastatic lymph nodes and their metastatic portions

One hundred and sixty two patients (69 patients without lymph node metastases and 93 patients with positive node metastases) out of patients with thoracic esophageal carcinoma resected within the past 12 years were studied regarding prognostic factors, with special reference to the number of positive nodes and their metastatic portions. Among patients with positive nodes, 5 years survival rates were 14.5% in patients with one or two positive nodes, 16.3% in patients with positive nodes only in the abdomen, 14.3% in patients with positive nodes only in the thorax, and 17.8% in patients with regional lymph node metastases (n1(+) and n2(+)). While among patients with distant lymph node metastases (n3(+) and n4(+)), with more than three positive nodes, or with positive nodes both in the thorax and abdomen, almost all of them expired due to recurrence within three years. Patients with one or two positive nodes and with positive nodes only in the abdomen who underwent postoperative irradiation combined with chemotherapy had a better prognosis than patients treated with postoperative irradiation alone or patients receiving no combined therapy.