Ma Longfei, Xiang Jiaqing, Zhang Yawei, Hu Hong, Shao Rongrong, Lin Dong
Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.
J BUON. 2017 Nov-Dec;22(6):1533-1539.
The recurrent laryngeal nerve lymph nodes (RLN LNs) are among the most common metastatic sites in esophageal cancer, and the dissection of these lymph nodes (LNs) is considered beneficial. The purpose of this study was to evaluate the characteristics of RLN LN metastases from esophageal squamous cell carcinoma, and the effects of these metastases on the prognosis of patients. In addition, we aimed to determine the reasonable range of dissection of regional LNs.
The clinical data from 348 patients who underwent resection for esophageal carcinoma were retrospectively analyzed.
Recurrent laryngeal nerve palsy occurred in 37.6% of the patients. In a subgroup of patients with lower esophageal tumors, cervical LN metastases were significantly more common in patients with positive rather than negative RLN LNs. The primary tumor site, tumor differentiation, and tumor invasion depth were factors that significantly influenced RLN LN metastasis. Multivariate analysis revealed that RLN LN metastasis was a significant factor associated with overall survival (OS) and disease-free survival (DFS) (p<0.001).
Metastasis to RLN LNs is a reliable indicator of cervical LN metastasis in middle/lower thoracic esophageal cancer. RLN LN metastasis may act as a prognostic indicator for patients with esophageal squamous cell carcinoma.
喉返神经淋巴结（RLN LNs）是食管癌最常见的转移部位之一，对这些淋巴结进行清扫被认为是有益的。本研究的目的是评估食管鳞状细胞癌喉返神经淋巴结转移的特征，以及这些转移对患者预后的影响。此外，我们旨在确定区域淋巴结清扫的合理范围。
回顾性分析348例行食管癌切除术患者的临床资料。
37.6%的患者发生喉返神经麻痹。在食管下段肿瘤患者亚组中，喉返神经淋巴结阳性患者的颈部淋巴结转移明显比阴性患者更常见。原发肿瘤部位、肿瘤分化程度和肿瘤浸润深度是显著影响喉返神经淋巴结转移的因素。多因素分析显示，喉返神经淋巴结转移是与总生存期（OS）和无病生存期（DFS）相关的显著因素（p<0.001）。
喉返神经淋巴结转移是胸段中下段食管癌颈部淋巴结转移的可靠指标。喉返神经淋巴结转移可能作为食管鳞状细胞癌患者的预后指标。
