Surgical outcome after the clearance of abdominal metastatic lymph nodes in 138 patients with thoracic esophageal carcinoma

Shimada, Hideaki; Okazumi, Shin-ichi; Matsubara, Hisahiro; Shiratori, Tooru; Shuto, Kiyohiko; Akutsu, Yasunori; Nabeya, Yoshihiro; Hayashi, Hideki; Ochiai, Takenori

doi:10.1016/j.amjsurg.2006.06.047

« Previous Next »The American Journal of Surgery
Volume 193, Issue 4 , Pages 448-452, April 2007

Surgical outcome after the clearance of abdominal metastatic lymph nodes in 138 patients with thoracic esophageal carcinoma

Hideaki Shimada, M.D.
- Department of Frontier Surgery (M9), Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
- Corresponding author. Tel.: +81 43 226 2110; fax: +81 43 226 2113.
Shin-ichi Okazumi, M.D.
- Department of Frontier Surgery (M9), Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
Hisahiro Matsubara, M.D.
- Department of Frontier Surgery (M9), Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
Tooru Shiratori, M.D.
- Department of Frontier Surgery (M9), Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
Kiyohiko Shuto, M.D.
- Department of Frontier Surgery (M9), Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
Yasunori Akutsu, M.D.
- Department of Frontier Surgery (M9), Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
Yoshihiro Nabeya, M.D.
- Department of Frontier Surgery (M9), Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
Hideki Hayashi, M.D.
- Research Center for Frontier Medical Engineering, Chiba University, Chiba, Japan
Takenori Ochiai, M.D.
- Department of Frontier Surgery (M9), Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan

Received 26 March 2006; received in revised form 2 June 2006

Abstract

Background

Although abdominal lymph node metastasis in patients with thoracic esophageal squamous cell carcinoma (SCC) has been reported to be a risk factor to reduce long-term survival, only a few studies have so far evaluated the clinicopathologic factors among this group of patients. The purpose of this study was to evaluate the patients’ surgical outcome after the clearance of metastatic abdominal nodes.

Patients and Methods

From 1980 to 2002, 550 consecutive patients with thoracic esophageal SCC underwent surgery with an abdominal lymph node dissection. A total of 138 patients with abdominal lymph node metastases were curatively resected. Those patients, including 62 from 1980 to 1989 and 76 from 1990 to 2002, were retrospectively reviewed. Univariate and multivariate analyses were performed to evaluate the impact of clinicopathologic factors on the survival of these patients.

Results

The overall 5-year survival rate of the 138 patients with abdominal lymph node metastases was 23%. A univariate analysis revealed that the following groups showed a greater than 30% overall 5-year survival rate: patients with T1 or T2 tumors, patients without thoracic node metastases, and those with poorly differentiated type tumors. Good prognostic factors based on a multivariate analysis were the most recent time period of surgery and 4 or fewer positive nodes.

Conclusion

Among the patients with abdominal lymph node metastases, those with T1 or T2 tumors, patients without thoracic node metastases, and patients with 4 or fewer positive nodes showed an acceptable overall survival after a curative resection.

Keywords: Esophageal cancer, Squamous cell carcinoma, Abdominal lymph node, Prognosis