Pre-tracheal lymph node metastasis in squamous cell carcinoma of the thoracic esophagus

Cliff P. Hsu, N. Y. Hsu, S. E. Shai, J. Y. Hsia, C. Y. Chen

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Aims: To clarify the incidence of pre-tracheal lymph node metastasis in squamous cell carcinoma of the esophagus, and their impact on survival. Methods: A cohort of 101 patients with squamous cell carcinoma of the thoracic esophagus who underwent esophagectomy together with 2-field lymphadenectomy including the pre-tracheal region was analysed, retrospectively. The p-TNM staging included stage I in 9, stage IIa in 33, stage IIb in 4, stage III in 43, and stage IV in 12 cases. Results: Nodal metastases were identified in 56 patients (55.4%). Subcarinal lymph node and pre-tracheal lymph-node metastases were found in 24 patients (23.8%) and 15 patients (14.9%), respectively. The 5-year cumulative survival rates were 26.5 and 2.5% in nodal negative and nodal positive patients, respectively. Patients with pre-tracheal nodal metastasis all died within 2 years. Cox proportional hazards model in patients with nodal involvement revealed T-factor (p=0.0017), pre-tracheal nodal involvement (p=0.0055) and distant metastasis (p=0.0024) as independent prognostic factors. Conclusions: Our findings suggest that pre-tracheal lymph node metastasis indicates a dismal prognosis. Its occurrence is not unusual, especially in tumour of upper or middle thoracic esophagus. The subcarinal node cannot be regarded as a sentinel node of the pre-tracheal nodal station. Complete lymphadenectomy excluding the pre-tracheal lymph nodes in treating esophageal cancers is only a myth.

Original languageEnglish
Pages (from-to)749-754
Number of pages6
JournalEuropean Journal of Surgical Oncology
Volume31
Issue number7
DOIs
Publication statusPublished - Sep 2005
Externally publishedYes

Fingerprint

Esophagus
Squamous Cell Carcinoma
Thorax
Lymph Nodes
Neoplasm Metastasis
Lymph Node Excision
Esophagectomy
Neoplasm Staging
Esophageal Neoplasms
Proportional Hazards Models
Survival Rate
Survival
Incidence
Neoplasms

Keywords

  • Esophageal cancer
  • Lymphadenectomy
  • Pre-tracheal node
  • Prognosis

ASJC Scopus subject areas

  • Oncology
  • Surgery

Cite this

Pre-tracheal lymph node metastasis in squamous cell carcinoma of the thoracic esophagus. / Hsu, Cliff P.; Hsu, N. Y.; Shai, S. E.; Hsia, J. Y.; Chen, C. Y.

In: European Journal of Surgical Oncology, Vol. 31, No. 7, 09.2005, p. 749-754.

Research output: Contribution to journalArticle

Hsu, Cliff P. ; Hsu, N. Y. ; Shai, S. E. ; Hsia, J. Y. ; Chen, C. Y. / Pre-tracheal lymph node metastasis in squamous cell carcinoma of the thoracic esophagus. In: European Journal of Surgical Oncology. 2005 ; Vol. 31, No. 7. pp. 749-754.
@article{3578b1eb5f034409b8c22b948e86474c,
title = "Pre-tracheal lymph node metastasis in squamous cell carcinoma of the thoracic esophagus",
abstract = "Aims: To clarify the incidence of pre-tracheal lymph node metastasis in squamous cell carcinoma of the esophagus, and their impact on survival. Methods: A cohort of 101 patients with squamous cell carcinoma of the thoracic esophagus who underwent esophagectomy together with 2-field lymphadenectomy including the pre-tracheal region was analysed, retrospectively. The p-TNM staging included stage I in 9, stage IIa in 33, stage IIb in 4, stage III in 43, and stage IV in 12 cases. Results: Nodal metastases were identified in 56 patients (55.4{\%}). Subcarinal lymph node and pre-tracheal lymph-node metastases were found in 24 patients (23.8{\%}) and 15 patients (14.9{\%}), respectively. The 5-year cumulative survival rates were 26.5 and 2.5{\%} in nodal negative and nodal positive patients, respectively. Patients with pre-tracheal nodal metastasis all died within 2 years. Cox proportional hazards model in patients with nodal involvement revealed T-factor (p=0.0017), pre-tracheal nodal involvement (p=0.0055) and distant metastasis (p=0.0024) as independent prognostic factors. Conclusions: Our findings suggest that pre-tracheal lymph node metastasis indicates a dismal prognosis. Its occurrence is not unusual, especially in tumour of upper or middle thoracic esophagus. The subcarinal node cannot be regarded as a sentinel node of the pre-tracheal nodal station. Complete lymphadenectomy excluding the pre-tracheal lymph nodes in treating esophageal cancers is only a myth.",
keywords = "Esophageal cancer, Lymphadenectomy, Pre-tracheal node, Prognosis",
author = "Hsu, {Cliff P.} and Hsu, {N. Y.} and Shai, {S. E.} and Hsia, {J. Y.} and Chen, {C. Y.}",
year = "2005",
month = "9",
doi = "10.1016/j.ejso.2005.03.009",
language = "English",
volume = "31",
pages = "749--754",
journal = "European Journal of Surgical Oncology",
issn = "0748-7983",
publisher = "W.B. Saunders Ltd",
number = "7",

}

TY - JOUR

T1 - Pre-tracheal lymph node metastasis in squamous cell carcinoma of the thoracic esophagus

AU - Hsu, Cliff P.

AU - Hsu, N. Y.

AU - Shai, S. E.

AU - Hsia, J. Y.

AU - Chen, C. Y.

PY - 2005/9

Y1 - 2005/9

N2 - Aims: To clarify the incidence of pre-tracheal lymph node metastasis in squamous cell carcinoma of the esophagus, and their impact on survival. Methods: A cohort of 101 patients with squamous cell carcinoma of the thoracic esophagus who underwent esophagectomy together with 2-field lymphadenectomy including the pre-tracheal region was analysed, retrospectively. The p-TNM staging included stage I in 9, stage IIa in 33, stage IIb in 4, stage III in 43, and stage IV in 12 cases. Results: Nodal metastases were identified in 56 patients (55.4%). Subcarinal lymph node and pre-tracheal lymph-node metastases were found in 24 patients (23.8%) and 15 patients (14.9%), respectively. The 5-year cumulative survival rates were 26.5 and 2.5% in nodal negative and nodal positive patients, respectively. Patients with pre-tracheal nodal metastasis all died within 2 years. Cox proportional hazards model in patients with nodal involvement revealed T-factor (p=0.0017), pre-tracheal nodal involvement (p=0.0055) and distant metastasis (p=0.0024) as independent prognostic factors. Conclusions: Our findings suggest that pre-tracheal lymph node metastasis indicates a dismal prognosis. Its occurrence is not unusual, especially in tumour of upper or middle thoracic esophagus. The subcarinal node cannot be regarded as a sentinel node of the pre-tracheal nodal station. Complete lymphadenectomy excluding the pre-tracheal lymph nodes in treating esophageal cancers is only a myth.

AB - Aims: To clarify the incidence of pre-tracheal lymph node metastasis in squamous cell carcinoma of the esophagus, and their impact on survival. Methods: A cohort of 101 patients with squamous cell carcinoma of the thoracic esophagus who underwent esophagectomy together with 2-field lymphadenectomy including the pre-tracheal region was analysed, retrospectively. The p-TNM staging included stage I in 9, stage IIa in 33, stage IIb in 4, stage III in 43, and stage IV in 12 cases. Results: Nodal metastases were identified in 56 patients (55.4%). Subcarinal lymph node and pre-tracheal lymph-node metastases were found in 24 patients (23.8%) and 15 patients (14.9%), respectively. The 5-year cumulative survival rates were 26.5 and 2.5% in nodal negative and nodal positive patients, respectively. Patients with pre-tracheal nodal metastasis all died within 2 years. Cox proportional hazards model in patients with nodal involvement revealed T-factor (p=0.0017), pre-tracheal nodal involvement (p=0.0055) and distant metastasis (p=0.0024) as independent prognostic factors. Conclusions: Our findings suggest that pre-tracheal lymph node metastasis indicates a dismal prognosis. Its occurrence is not unusual, especially in tumour of upper or middle thoracic esophagus. The subcarinal node cannot be regarded as a sentinel node of the pre-tracheal nodal station. Complete lymphadenectomy excluding the pre-tracheal lymph nodes in treating esophageal cancers is only a myth.

KW - Esophageal cancer

KW - Lymphadenectomy

KW - Pre-tracheal node

KW - Prognosis

UR - http://www.scopus.com/inward/record.url?scp=23944518672&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=23944518672&partnerID=8YFLogxK

U2 - 10.1016/j.ejso.2005.03.009

DO - 10.1016/j.ejso.2005.03.009

M3 - Article

VL - 31

SP - 749

EP - 754

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

SN - 0748-7983

IS - 7

ER -