Qingjie Yang,Zhong Li,Ming Guo. A clinical study of thoracic esophageal carcinoma metastasis into abdominal lymph nodes. Oncol Transl Med, 2016, 2: 8-11.
A clinical study of thoracic esophageal carcinoma metastasis into abdominal lymph nodes
Received:April 15, 2015  Revised:January 27, 2016
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KeyWord:esophageal carcinoma; abdominal lymph node; metastasis
Author NameAffiliationE-mail
Qingjie Yang Department of Cardiothoracic Surgery, The Affiliated Chenggong of Hospital, Xiamen University, Xiamen 361003, yqj00001@163.com 
Zhong Li Department of Cardiothoracic Surgery, The Affiliated Chenggong of Hospital, Xiamen University, Xiamen 361003, yqj00002@163.com 
Ming Guo Department of Cardiothoracic Surgery, The Affiliated Chenggong of Hospital, Xiamen University, Xiamen 361003, goum174@163.com 
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Abstract:
      Objective: The aim of this study was to analyze the potential of thoracic esophageal carcinoma to metastasize into abdominal lymph nodes. Methods: The data on abdominal lymph node metastasis in 164 patients who had undergone resection of thoracic esophageal carcinoma were analyzed retrospectively and grouped according to tumor position in the upper, middle, or lower thoracic esophagus. The difference in tumor infiltration depth, differentiation degree, pathological type, pathological stage, and the metastasis rate in abdominal lymph nodes among the three groups was evaluated and the correlation of abdominal lymph node metastasis with tumor infiltration depth, differentiation degree, and pathological type was analyzed. Results: Clinical characteristics such as tumor infiltration depth, differentiation degree, pathological type, and pathological stage were not significantly different between the patients with upper, middle, and lower thoracic esophageal carcinomas. Although there was a difference in the metastasis rate in abdominal lymph nodes between the three groups (6.9%, 27.4%, and 39.6% for the upper, middle, and lower thoracic esophageal carcinomas, respectively), it was not statistically significant. There was also no association between the rate of abdominal lymph node metastasis and tumor infiltration depth, differentiation degree, and pathological type. Conclusion: Esophageal carcinoma specifically metastasizes into lymph nodes. If the tumor infiltrates the upper thoracic submucosa, it could metastasize down to abdominal lymph nodes via the lymphatic capillary net. The majority of esophageal carcinomas were of T1b or higher pathological stage at the diagnosis, indicating infiltration of the submucosa. Thus, tumors of the early stage, high degree of differentiation, or position in the upper thoracic esophagus were not less prone to metastasis into abdominal lymph nodes. Therefore, routine abdominal lymph node dissection during radical surgery for esophageal carcinoma is necessary.
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