An evaluation of malignancy and prognostic factors based on mode of lymph node metastasis in esophageal carcinoma

This study was conducted to evaluate lymph node metastasis as a key prognos tic factor in esophageal cancer. Metastatic lesions in lymph nodes were gro uped by histological morphology as intracapsular or extracapsular, and the significance of lymph node metastasis was evaluated by relating metastatic lesions to clinical pathologic factors and patient prognosis. In our hospit al, 46 of 81 patients who underwent resection of esophageal cancer develope d lymph node metastasis. These 46 patients were enrolled in a study analyzi ng the relationship between the metastatic mode and the clinicopathological factors. The frequency of extracapsular metastasis was significantly high in patients with a profound depth of cancer, three or more metastases, dist ant metastasis (n3 and n4), or severe lymphatic invasion. The prognosis was significantly worse in patients with extracapsular metastasis, and this te ndency was also seen even in patients with three or more metastases, limite d metastasis (n1 and n2), or mild lymphatic invasion (ly0 and ly1). These f indings suggest that the metastatic mode reflects the degree of esophageal cancer progression and is an important prognostic factor.