Patterns of Regional Lymph Node Recurrence After Radical Surgery for Thoracic Esophageal Squamous Cell Carcinoma.

ABSTRACT

BACKGROUND: This study aimed to investigate the patterns of regional lymph node recurrence after radical surgery for thoracic esophageal squamous cell carcinoma (ESCC). METHODS: We retrospectively reviewed clinical characteristics of ESCC patients admitted to two institutions from 1990 to 2011, and analyzed the patterns of regional lymph node recurrence. RESULTS: The records of 315 eligible patients with ESCC were reviewed. Of the 378 regional lymph node recurrence sites, 177 (46.8%) were in the supraclavicular areas, 120 (31.7%) in the mediastinum, and 81 (21.4%) in the upper abdominal areas. The most common sites of recurrence were the supraclavicular and mediastinum areas in patients with upper and middle thoracic ESCC. Approximately equal percentages of patients with lower thoracic tumors had supraclavicular, mediastinal, and upper abdominal (celiac) lymph node recurrence. Patients with tumor located in the lower thoracic esophagus had a lower probability of supraclavicular lymph node recurrence (p = 0.013). None of the assessed factors was associated with mediastinal lymph node recurrence. Celiac lymph node recurrence was more frequent among patients with lower thoracic ESCC (p = 0.004) and advanced pathologic nodal (pN) stage (pN2, p = 0.034; pN3, p = 0.009). CONCLUSIONS: After radical surgery for thoracic ESCC, the patterns of regional lymph node recurrence are related to the tumor location and pN stage.