Wu San-Gang, Dai Ming-Ming, He Zhen-Yu, Sun Jia-Yuan, Lin Huan-Xin, Lin Hui, Li Qun
Department of Radiation Oncology, Xiamen Cancer Center, First Affiliated Hospital of Xiamen University, Xiamen, China.
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
Ann Thorac Surg. 2016 Feb;101(2):551-7. doi: 10.1016/j.athoracsur.2015.08.057. Epub 2015 Oct 31.
This study aimed to investigate the patterns of regional lymph node recurrence after radical surgery for thoracic esophageal squamous cell carcinoma (ESCC).
We retrospectively reviewed clinical characteristics of ESCC patients admitted to two institutions from 1990 to 2011, and analyzed the patterns of regional lymph node recurrence.
The records of 315 eligible patients with ESCC were reviewed. Of the 378 regional lymph node recurrence sites, 177 (46.8%) were in the supraclavicular areas, 120 (31.7%) in the mediastinum, and 81 (21.4%) in the upper abdominal areas. The most common sites of recurrence were the supraclavicular and mediastinum areas in patients with upper and middle thoracic ESCC. Approximately equal percentages of patients with lower thoracic tumors had supraclavicular, mediastinal, and upper abdominal (celiac) lymph node recurrence. Patients with tumor located in the lower thoracic esophagus had a lower probability of supraclavicular lymph node recurrence (p = 0.013). None of the assessed factors was associated with mediastinal lymph node recurrence. Celiac lymph node recurrence was more frequent among patients with lower thoracic ESCC (p = 0.004) and advanced pathologic nodal (pN) stage (pN2, p = 0.034; pN3, p = 0.009).
After radical surgery for thoracic ESCC, the patterns of regional lymph node recurrence are related to the tumor location and pN stage.
本研究旨在调查胸段食管鳞状细胞癌（ESCC）根治性手术后区域淋巴结复发的模式。
我们回顾性分析了1990年至2011年期间两所机构收治的ESCC患者的临床特征，并分析了区域淋巴结复发的模式。
共回顾了315例符合条件的ESCC患者的记录。在378个区域淋巴结复发部位中，177个（46.8%）位于锁骨上区域，120个（31.7%）位于纵隔，81个（21.4%）位于上腹部区域。胸段食管上段和中段ESCC患者最常见的复发部位是锁骨上和纵隔区域。胸段食管下段肿瘤患者锁骨上、纵隔和上腹部（腹腔）淋巴结复发的比例大致相等。肿瘤位于胸段食管下段的患者锁骨上淋巴结复发的概率较低（p = 0.013）。所评估的因素均与纵隔淋巴结复发无关。腹腔淋巴结复发在胸段食管下段ESCC患者（p = 0.004）和晚期病理淋巴结（pN）分期（pN2，p = 0.034；pN3，p = 0.009）患者中更为常见。
胸段ESCC根治性手术后，区域淋巴结复发模式与肿瘤位置和pN分期有关。
