Baba M, Aikou T, Natsugoe S, Kusano C, Shimada M, Kimura S, Fukumoto T
First Department of Surgery, Faculty of Medicine, Kagoshima University, Japan.
J Surg Oncol. 1997 Jan;64(1):12-6. doi: 10.1002/(sici)1096-9098(199701)64:1<12::aid-jso3>3.0.co;2-s.
Lymph node metastasis is a definitive prognostic factor; however, perinodal fat tumor invasion has not been fully elucidated.
Periesophageal nodes and the surrounding fibrofatty tissue obtained from 131 patients who underwent esophagectomy were examined.
Of 9,789 nodes removed, 645 (6.6%) demonstrated invasion and 143 (1.5%) showed perinodal involvement. Of 131 patients 97 (74.0%) had lymph node involvement and 43 (32.8%) had perinodal fat involvement. The incidence of perinodal tissue involvement correlated significantly with the number of nodes involved; 23 (42.6%) of 54 patients with a total of 1-8 nodes involved and 19 (95.0%) of 20 patients with 9 or more involved nodes had perinodal involvement. The 5-year survival for 33 patients without involved nodes or perinodal tissue extension was 59.7%, compared to 14.0% for 43 patients with perinodal fat involvement.
Perinodal tissue carcinoma into the periesophageal fibrofatty tissue was a decisive prognostic factor in patients with curative resection for esophageal carcinoma.
淋巴结转移是一个明确的预后因素；然而，结周脂肪组织受肿瘤侵犯的情况尚未完全阐明。
对131例行食管切除术患者的食管旁淋巴结及周围纤维脂肪组织进行检查。
在切除的9789个淋巴结中，645个（6.6%）显示有侵犯，143个（1.5%）显示有结周受累。131例患者中，97例（74.0%）有淋巴结受累，43例（32.8%）有结周脂肪受累。结周组织受累的发生率与受累淋巴结的数量显著相关；在总共1 - 8个淋巴结受累的54例患者中，23例（42.6%）有结周受累，在9个或更多淋巴结受累的20例患者中，19例（95.0%）有结周受累。33例无淋巴结或结周组织受累的患者5年生存率为59.7%，而43例有结周脂肪受累的患者5年生存率为14.0%。
食管癌根治性切除患者中，癌组织侵犯食管旁纤维脂肪组织是一个决定性的预后因素。
