Hosokawa M
Department of Surgery, Keiyukai Sapporo Hospital, Japan.
Nihon Geka Gakkai Zasshi. 1997 Sep;98(9):751-4.
The incidence of metastasis to the lymph nodes in preoperative untreated patients with Ei, T2 or T3 esophageal cancer is 70.7% (41 of 58 cases) in our institute. Especially, a high incidence of metastasis to the abdominal lymph nodes has been noted. In contrast, metastasis to the cervical lymph nodes is not common. The majority of recurrence appear as a distant metastasis to the liver, lung or bone through the hematogenic route. However, recurrence in the peritoneum through the lymphatogenic route is not uncommon. Therefore, current strategy of lymph nodes dissection for esophageal carcinoma would be inadequate for the complete inhibition of recurrence, so that chemotherapy remains to be needed. Since the diagnostic procedure with ultrasonographic endoscopy and computerized tomography is highly accurate for the assessment of metastasis to the uppermediastinal lymph nodes, operative procedure suitable for each case should be determined on the basis of preoperative examination.
在我院，术前未经治疗的E1、T2或T3期食管癌患者发生淋巴结转移的发生率为70.7%（58例中的41例）。特别是，已注意到腹主动脉旁淋巴结转移的发生率很高。相比之下，颈部淋巴结转移并不常见。大多数复发表现为通过血行途径远处转移至肝脏、肺或骨。然而，通过淋巴途径在腹膜复发并不少见。因此，目前食管癌淋巴结清扫策略对于完全抑制复发是不够的，所以仍需要化疗。由于超声内镜和计算机断层扫描的诊断程序对评估上纵隔淋巴结转移具有高度准确性，应根据术前检查确定适合每种情况的手术方式。
