Original articleGeneral thoracicA Strategy for Supraclavicular Lymph Node Dissection Using Recurrent Laryngeal Nerve Lymph Node Status in Thoracic Esophageal Squamous Cell Carcinoma
Section snippets
Patients and Methods
From January 1986 to 2011, 926 patients with esophageal cancer underwent esophagectomy in our single institution. Among them, we selected patients according to the following criteria to obtain the exact data of RLN LN state and exclude residual cancer cases: (1) T1 to T3 squamous cell carcinoma cases; (2) underwent the McKeown procedure; (3) a bilateral RLN LN dissection was performed; (4) an R0 resection was done; (5) the surgical margin was pathologically negative; (6) there was no treatment
Results
The clinical and pathologic characteristics of the study population are summarized in Table 1. Nineteen patients had cancer metastasis in the SC LN at the time of surgery and 22 patients had metastasis in the SC LN after surgery. Among 22 cases, 3 cases had lung metastasis and 2 cases had liver metastasis at the same time that SC LN metastasis had occurred. In upper esophageal cancer cases, 66.7% of the patients had RLN LN metastasis and 33.3% had SC LN metastasis (Table 2). Among all patients
Comment
The LN dissection of esophageal cancer patients has long been controversial. Because the frequency of metastasis around the RLN has been well known in thoracic esophageal cancer patients 1, 2, 3, 4, there would be no argument about dissecting these LNs. Moreover, because there is no obvious borderline between the thoracic and cervical RLN, we should dissect the LNs around the cervical RLN as well. In the UICC seventh edition, the cervical paraesophageal LN was defined as regional LN. Because
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