华西医院李真林 Patterns of lymph node recurrence after radical surgery impacting on survival of patients with pT1-3N0M0 thoracic esophageal squamous cell carcinoma.

 J Korean Med Sci. 2014 Feb;29（2）:217-23. doi: 10.3346/jkms.2014.29.2.217. Epub 2014 Jan 28.

Patterns of lymph node recurrence after radical surgery impacting on survival of patients with pT1-3N0M0 thoracic esophageal squamous cell carcinoma.

Chen XL¹, Chen TW², Fang ZJ³, Zhang XM², Li ZL³, Li H², Tang HJ², Zhou L², Wang D², Zhang Z⁴.

Author information

• ¹Sichuan      Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated      Hospital of North Sichuan Medical College, Nanchong, Sichuan, China. ;      Department of Radiology, Sichuan Cancer Hospital and Institute （The Second People's Hospital of      Sichuan Province）, Chengdu, Sichuan, China.

• ²Sichuan      Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated      Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.

• ³Department      of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan,      China.

• ⁴Department      of Radiology, University of Michigan Health System, Ann Arbor, MI, USA.

Abstract

The aim of this study was to investigate how patterns of lymph nodes recurrence after radical surgery impact on survival of patients with pT1-3N0M0 thoracic esophageal squamous cell carcinoma. One hundred eighty consecutive patients with thoracic esophageal squamous cell carcinoma underwent radical surgery, and the tumors were staged as pT1-3N0M0 by postoperative pathology. Lymph nodes recurrence was detected with computed tomography 3-120 months after the treatment. The patterns of lymph nodes recurrence including stations, fields and locations of recurrent lymph nodes, and impacts on patterns of survival were statistically analyzed. There was a decreasing trend of overall survival with increasing stations or fields of postoperative lymph nodes involved （all P<0.05）. Univariate analysis showed that stations or fields of lymph nodes recurrence, and abdominal or cervical lymph nodes involved were prognostic factors for survival （all P<0.05）. Cox analyses revealed that the field was an independent factor （P<0.05, odds ratio=2.73）. Lymph nodes involved occurred predominantly in cervix and upper mediastinum （P<0.05）. In conclusion, patterns of lymph node recurrence especially the fields of lymph nodes involved are significant prognostic factors for survival of patients with pT1-3N0M0 thoracic esophageal squamous cell carcinoma.

KEYWORDS:

Esophageal Squamous Cell Carcinoma; Lymph Node Recurrence; Radical Esophagectomy; Thorax; Tomography, X-Ray Computed

PMID: 24550648 PMCID: PMC3924000 DOI: 10.3346/jkms.2014.29.2.217