PROGNOSTIC VALUE OF THORACIC RECURRENT NERVE NODAL INVOLVEMENT IN ESOPHAGEAL SQUAMOUS-CELL CARCINOMA

Background: The determination of a simple and reliable prognostic fact or that allows identification of patients at high risk of early cancer recurrence and subsequent death after resection of esophageal carcino ma should contribute to more accurate management of patients suffering from this disease. Study Design: The aim of this study was to assess the prognostic value of thoracic recurrent nerve nodal involvement aft er curative resection of esophageal squamous cell carcinoma. The progn ostic importance of gender, age, tumor penetration, and extent of lymp h node involvement was evaluated in 55 patients after curative resecti on of esophageal squamous cell carcinoma. Results: Thirty-four of 55 p atients (62%) had nodal metastases and 10 of 55 (18%) had thoracic rec urrent nerve nodes involved. The median overall survival was 28 months . By univariate analysis, survival was higher in association with the absence of adventitial invasion (p = 0.04), of nodal involvement (p = 0.03), and of thoracic recurrent nerve nodal involvement (p = 0.0001). In a Cox proportional hazards regression model, thoracic recurrent ne rve nodal involvement appeared the strongest predictive factor (adjust ed hazard ratio 8.4 (3.0-23.7)). Conclusions: Assessment of thoracic r ecurrent nerve nodes is appropriate to identify patients who are at hi gh risk of disease-related death after surgical resection. (C) 1997 by the American College of Surgeons.