Pattern of lymph node metastases of esophageal squamous cell carcinoma based on the anatomical lymphatic drainage system

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
Y TachimoriH Igaki

Abstract

The recent anatomical studies of the esophagus showed that submucosal longitudinal lymphatic vessels connect to the superior mediastinal and the paracardial lymphatics and lymphatic routes to periesophageal nodes originate from the muscle layer. Using clinical data for lymph node metastasis, we verify these anatomical bases to clarify the rational areas of lymph node dissection in esophageal cancer surgery. Analysis was performed on 356 consecutive patients who underwent esophagectomy with three-field dissection. Patients were divided into those with tumor limited within the submucosal layer and those with tumor invading or penetrating the muscle layer. Frequency of node metastasis was compared according to supraclavicular, upper mediastinum, mid-mediastinum, lower mediastinum, perigastric and celiac areas. In patients with tumor limited to the submucosal layer, node metastasis was more frequent in the upper mediastinum and perigastric area than the mid- or lower mediastinum. Even in patients with tumor located in the lower esophagus, node metastasis was more frequent in the upper mediastinum than the mid-mediastinum or lower mediastinum. In patients with tumor located in the mid-esophagus, node metastasis was more frequent in ...Continue Reading

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Citations

Mar 27, 2013·General Thoracic and Cardiovascular Surgery·Yasunori Akutsu, Hisahiro Matsubara
Jul 31, 2013·Annals of Surgical Oncology·Shin-ichi KosugiToshifumi Wakai
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