PROGNOSTIC-SIGNIFICANCE OF LYMPH-NODE METASTASIS IN SURGICAL RESECTION OF ESOPHAGEAL CANCER

Objective. Although surgery is relatively successful in eradicating lo cal tumor, post-resection five-year survival rate for esophageal cance r is still lower than 30%. Multiple factors are found to influence the long-term results after surgical treatment. However, recent investiga tions have focused on the significance of lymph node matastasis (LNM), which seems to be one of the most important factors leading to poor s urvival. Hence, the prognostic significance of LNM in surgical resecti on of esophageal cancer was studied. Methods. The rate and degree of L NM were evaluated and their prognostic significance was investigated t hrough a retrospective study of 474 patients with esophageal cancer tr eated by surgery alone. Results. LNM was positive in 211 patients, wit h an incidence of 44.5% (211/474). A total of 5382 lymph nodes were re sected and studied pathologically, among which metastasis was found in 690 nodes with an overall LNM degree of 12.8% (690/5382). The 5-year survival rate was 30.6% (145/474) in the entire series, 12.8% (27/211) in patients with LNM, and 44.9% (118/263) in those without LNM.Conclu sions. Surgery remains the first choice of treatment for carcinoma of the esophagus, and that meticulous lymph node dissection is an importa nt practice of surgical oncology. However, in more advanced cases of t his disease, surgery alone is of limited value in eradicating all canc er compromized tissue, and therefore the routine practice of extensive lymph node dissection in such cases may not be rewarding.