Abstract:

Background and purpose: Lymph node (LN) metastasis of esophageal cancer of neck rate higher, but there is little bulk reports. This article aimed to analyze the characteristics of cervical lymph node metastasis (CLN) in thoracic esophageal squamous cell carcinoma (TE-SCC) and the clinical role. Methods: A total number of 1 131 TE-SCC patients underwent radical esophagectomy plus three-field lymph node dissection at Fujian Provincial Tumor Hospital between Jan. 1993 to Dec. 2003, during which, 367 patients had pathological metastasis of CLN. Results: The metastatic rate of CLN was 33.2% for the entire group, 43.7%, 33.0% and 16.0% for the upper, middle and lower TE-SCC respectively. Single factor analysis showed that the metastatic rate of CLN was relevant with the tumor site, pathological differentiated degree, lesion length showed in X-ray, pT stage and the number of CLN (P<0.05). But multivariate regression analysis showed that the metastatic rate of CLN was just relevant with the tumor site, pT stage and the number of CLN (P<0.05). Metastasis of cervical paraesophageal lymph nodes was the most common, and supraclavicular lymph node metastasis was next, and metastasis of cervical profound lymph nodes and retropharyngeal lymph nodes were rare. The ratio of the number of CLN occupied the sum of the segmental CLN were 57.7%, 32.0% and 10.0% for the upper, middle and lower TE-SCC respectively (P<0.05). Right CLN of each segmental TE-SCC was more than left CLN. Conclusion: Independent factors on CLN in TE-SCC are the tumor site, pT stage and the number of CLN. Metastasis of cervical paraesophageal lymph nodes is the most common, and supraclavicular lymph node metastasis is next, and metastasis of cervical profound lymph nodes and retropharyngeal lymph nodes are rare. 　

Key words: Esophageal neoplasm, Cervical lymph node metastasis, Number of lymph node metastasis, Rate of lymph node metastasis