Characteristics and risk factors of lymph node metastases in esophageal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the status of lymph node metastases (LNM) of esophageal carcinoma and to identify the risk factors.</p><p><b>METHODS</b>Clinical data of 308 patients who underwent esophagectomy with three-field lymphadenectomy during January 2006 and December 2010 were reviewed. Characteristics of LNM were studied.</p><p><b>RESULTS</b>The average number of dissected lymph nodes was 35.6 ± 14.5 in 308 patients. There were 197 patients(64%) had LNM. Logistic regression analysis showed that lymphatic vessel invasion(P=0.019) and deep tumor invasion(P<0.001) were risk factors of LNM. The highest LNM site was paratracheal node(25.0%). The incidence of cervical LNM was 14.1% in the middle thoracic carcinoma, higher than that of upper thoracic (7.3%) and lower thoracic (8.3%). Rate of LNM was lower in upper thoracic carcinomas than that in middle or lower ones(P=0.001). No significant difference of LNM was found among upper, middle and lower thoracic carcinoma for cervical or thoracic nodes. Lymphatic vessel invasion(P<0.001) and metastases in paratracheal lymph nodes (P=0.014) were risk factors for cervical LNM.</p><p><b>CONCLUSIONS</b>LNM of esophageal carcinoma can be found in both directions vertically and skipped metastasis. Paratracheal lymph nodes involvement is an indicator for cervical lymphadenectomy in thoracic esophageal carcinoma.</p>

Comparison of mini-probe endoscopic ultrasonography with computed tomography in preoperative staging of esophageal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare mini-probe endoscopic ultrasonography (MCUS) with computed tomography (CT) in preoperative T and N staging of esophageal cancer, and to find out the MCUS parameters to judge lymph node metastasis for esophageal cancer.</p><p><b>METHODS</b>Thirty-five patients received both MCUS and CT preoperatively, on both of which the T and N stages were determined. The accuracy, sensitivity, specificity, positive predicting value and negative predicting value were compared with the postoperative pathological results.</p><p><b>RESULTS</b>The accuracy of MCUS was 85.7% in T staging and 85.7% and 80.0% in N staging by the two different methods, which were 45.7% and 74.3%, respectively, by CT.</p><p><b>CONCLUSION</b>MCUS is better than CT in preoperative staging for esophageal cancer. The ratio of short to long axis (S/L) combined with short axis is a useful way to determine lymph node metastasis.</p>