ABSTRACT
BACKGROUND: Lymphoepithelioma-like carcinoma (LELC) is a rare form of non-small cell lung carcinoma. The current study focused on its clinicopathological features and potential factors influencing the prognosis. METHODS: The statistical analysis was based on the clinicopathological records and the prognosis of 43 LELC patients, analyzed by Kaplan-Meier method, Log-rank test, and COX regression analysis. RESULTS: The patients' average age was 57.35±9.22 years, 86.05% of them were non-smokers and 53.49% were women. The average tumor diameter was 3.24±1.57 cm. The 2- and 5-year overall survival (OS) rates of LELC patients were 90% and 74%, respectively; the disease-free survival (DFS) rates were 87% and 47%, respectively. The patients with large tumor, accompanied with lymph nodes metastasis or at the advanced stage had the worst OS, and the patients with lymph nodes metastasis or at the advanced stage had the worst DFS. Univariate analysis indicated that T and N grading and TNM stage influenced the OS, and N grading and TNM stage influenced the DFS; the independent factors affecting OS or DFS were not identified by multivariate analysis. CONCLUSIONS: LELC commonly occurred in senior non-smoking women. In summary, the prognosis of LELC was satisfactory.
ABSTRACT
OBJECTIVE: To investigate the lymph node metastasis and the rational lymphadenectomy in thoracic esophageal carcinoma. METHODS: Eighty-seven patients with thoracic esophageal squamous carcinoma received esophagectomy plus two-field or three-field lymphadenectomy based on cervical ultrasonography. RESULTS: Thirty-five patients (40.2% ) with enlarged cervical nodes revealed by cervical ultrasonography received cervical lymphadenectomy. The proportion of cervical lymphadenectomy was 66.7% (16/24) in upper thoracic esophageal carcinomas, significantly higher than 30.2% (19/63) in middle and lower esophageal carcinomas (P=0.002). Regional and cervical lymph node metastasis were found in 48(55.2% ) and 17(19.5% ) patients respectively. The regional lymph node metastatic rates were 37.5% (9/24), 62.3% (33/53) and 60.0% (6/10) respectively in the patients with upper, middle, and lower thoracic esophageal carcinoma. The cervical lymph node metastatic rates in the patients with or without regional lymph node metastasis were 31.3% (15/48) and 5.1% (2/39) respectively(P=0.002). The rates of upper, mid, lower mediastinal and upper abdominal lymph node metastasis were 25.3%, 23.0%, 5.7%, and 24.1% respectively. Cervical lymph node metastasis was significantly correlated with upper and mid mediastinal metastasis (both P< 0.01), but not with lower mediastinal and upper abdominal lymph node metastasis. The overall postoperative morbidity rate was significantly higher in three field lymphadenectomy group than that in two field group(60.0% vs. 34.6%, P=0.020). CONCLUSION: Selective 3-field lymphadenectomy based on cervical ultrasonography should be performed in thoracic esophageal carcinoma, especially with upper and mid mediastinal lymph node metastasis.