Clinical analysis of the predictive value of recurrent laryngeal nerve lymph nodes status for supraclavicular lymph node metastasis in esophageal squamous cell carcinoma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 ZHENG Xiaodong , ZHANG Weimin , HOU Jianbin

Department of Thoracic Surgery, Anyang Tumor Hospital, Anyang, 455000, Henan, P.R.China;

Corresponding author：

ZHENG Xiaodong, Email: 18898768@qq.com

Keywords：

Esophageal cancer; three-field lymph node dissection; recurrent laryngeal nerve lymph node; supraclavicular lymph node

DOI：

10.7507/1007-4848.201906011

Video：

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Objective To investigate the predictive value of recurrent laryngeal nerve lymph nodes (RLN) status for supraclavicular lymph node (SLN) metastasis in esophageal squamous cell carcinoma.Methods We retrospectively analyzed the clinical data of 83 patients with esophageal squamous cell carcinoma who underwent McKeown three-field lymphadenectomy from January 2017 to April 2018 in our hospital, including 53 males and 30 females with an average age of 64.07±7.05 years.Results The SLN metastasis rate of the patients was 24.1%. The rate in the thoracic and abdominal metastases positive (N_1-3) group and negative (N₀) group was 37.8% and 13.0%, respectively, with a statistical difference (P<0.05). The rate of SLN metastasis was significantly different between the RLN metastasis positive (RLN+) and negative (RLN–) groups (39.1% vs. 18.3%, P<0.05). One side of RLN metastasis could lead to SLN metastasis on the opposite side. No correlation between the SLN metastasis and age, gender, location, differentiation degree, maximum tumor diameter, T-staging or histologic type was observed (P>0.05). Multivariate analysis showed that lymph node metastasis in chest or abdomen was an independent predictor of SLN metastasis.Conclusion RLN+ is not the independent predictor for SLN metastasis. SLN should be dissected in N_1-3 patients with esophageal squamous cell carcinoma without considering tumor location and T-staging. Bilateral SLN dissection should be recommended even if RLN metastasis is only unilateral.

Citation： ZHENG Xiaodong, ZHANG Weimin, HOU Jianbin. Clinical analysis of the predictive value of recurrent laryngeal nerve lymph nodes status for supraclavicular lymph node metastasis in esophageal squamous cell carcinoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(3): 297-302. doi: 10.7507/1007-4848.201906011 Copy

1.	Kato H, Watanabe H, Tachimori Y, et al. Evaluation of neck lymph node dissection for thoracic esophageal carcinoma. Ann Thorac Surg, 1991, 51(6): 931-935.
2.	Altorki N, Kent M, Ferrara C, et al. Three-field lymph node dissection for squamous cell and adenocarcinoma of the esophagus. Ann Surg, 2002, 236(2): 177-183.
3.	Fujita H, Kakegawa T, Yamana H, et al. Mortality and morbidity rates, postoperative course, quality of life, and prognosis after extended radical lymphadenectomy for esophageal cancer. Comparison of three-field lymphadenectomy with two-field lymphadenectomy. Ann Surg, 1995, 222(5): 654-662.
4.	李志刚. 胸腔镜下双侧颈部喉返神经旁(101 组)淋巴结清扫及相关解剖标志. 中华胸部外科电子杂志, 2015, 2(2): 136.
5.	Shim YM, Kim HK, Kim K. Comparison of survival and recurrence pattern between two-field and three-field lymph node dissections for upper thoracic esophageal squamous cell carcinoma. J Thorac Oncol, 2010, 5(5): 707-712.
6.	Taniyama Y, Nakamura T, Mitamura A, et al. A strategy for supraclavicular lymph node dissection using recurrent laryngeal nerve lymph node status in thoracic esophageal squamous cell carcinoma. Ann Thorac Surg, 2013, 95(6): 1930-1937.
7.	Ma GW, Situ DR, Ma QL, et al. Three-field vs. two-field lymph node dissection for esophageal cancer: a meta-analysis. World J Gastroenterol, 2014, 20(47): 18022-18030.
8.	Li H, Fang W, Yu Z, et al. Chinese expert consensus on mediastinal lymph node dissection in esophagectomy for esophageal cancer (2017 edition). J Thorac Dis, 2018, 10(4): 2481-2489.
9.	Davies AR, Sandhu H, Pillai A, et al. Surgical resection strategy and the influence of radicality on outcomes in oesophageal cancer. Br J Surg, 2014, 101(5): 511-517.
10.	Ueda Y, Shiozaki A, Itoi H, et al. Intraoperative pathological investigation of recurrent nerve nodal metastasis can guide the decision whether to perform cervical lymph node dissection in thoracic esophageal cancer. Oncol Rep, 2006, 16(5): 1061-1066.
11.	翁军玲, 田辉, 李鲁波. 食管癌患者胸内喉返神经旁淋巴结转移与颈部淋巴结的关联性. 世界华人消化杂志, 2016, 24(16): 2537-2542.
12.	Tachimori Y, Nagai Y, Kanamori N, et al. Pattern of lymph node metastases of esophageal squamous cell carcinoma based on the anatomical lymphatic drainage system. Dis Esophagus, 2011, 24(1): 33-38.
13.	Shang QX, Chen LQ, Hu WP, et al. Three-field lymph node dissection in treating the esophageal cancer. J Thorac Dis, 2016, 8(10): E1136-E1149.
14.	段孝凤, 高晓旭, 顾宪文. 序贯三切口及选择性淋巴结清扫治疗食管癌1162例临床效果分析. 肿瘤研究与临床, 2014, 26(6): 381-385.
15.	沈国义, 张文山, 张奕, 等. 术中胸内喉返神经旁淋巴结冰冻在指导胸段食管鳞癌三野淋巴结清扫的意义. 福建医科大学学报, 2017, 51(4): 240-244.
16.	朱德奇, 李春霖, 王忠民, 等. PT_1-3N₀M₀胸段食管鳞癌术后颈部淋巴结转移危险因素分析. 中国实验诊断学, 2019, 23(4): 623-625.
17.	Shao L, Ye T, Ma L, et al. Three-field versus two-field lymph node dissection for thoracic esophageal squamous cell carcinoma: a propensity score-matched comparison. J Thorac Dis, 2018, 10(5): 2924-2932.

1. Kato H, Watanabe H, Tachimori Y, et al. Evaluation of neck lymph node dissection for thoracic esophageal carcinoma. Ann Thorac Surg, 1991, 51(6): 931-935.
2. Altorki N, Kent M, Ferrara C, et al. Three-field lymph node dissection for squamous cell and adenocarcinoma of the esophagus. Ann Surg, 2002, 236(2): 177-183.
3. Fujita H, Kakegawa T, Yamana H, et al. Mortality and morbidity rates, postoperative course, quality of life, and prognosis after extended radical lymphadenectomy for esophageal cancer. Comparison of three-field lymphadenectomy with two-field lymphadenectomy. Ann Surg, 1995, 222(5): 654-662.
4. 李志刚. 胸腔镜下双侧颈部喉返神经旁(101 组)淋巴结清扫及相关解剖标志. 中华胸部外科电子杂志, 2015, 2(2): 136.
5. Shim YM, Kim HK, Kim K. Comparison of survival and recurrence pattern between two-field and three-field lymph node dissections for upper thoracic esophageal squamous cell carcinoma. J Thorac Oncol, 2010, 5(5): 707-712.
6. Taniyama Y, Nakamura T, Mitamura A, et al. A strategy for supraclavicular lymph node dissection using recurrent laryngeal nerve lymph node status in thoracic esophageal squamous cell carcinoma. Ann Thorac Surg, 2013, 95(6): 1930-1937.
7. Ma GW, Situ DR, Ma QL, et al. Three-field vs. two-field lymph node dissection for esophageal cancer: a meta-analysis. World J Gastroenterol, 2014, 20(47): 18022-18030.
8. Li H, Fang W, Yu Z, et al. Chinese expert consensus on mediastinal lymph node dissection in esophagectomy for esophageal cancer (2017 edition). J Thorac Dis, 2018, 10(4): 2481-2489.
9. Davies AR, Sandhu H, Pillai A, et al. Surgical resection strategy and the influence of radicality on outcomes in oesophageal cancer. Br J Surg, 2014, 101(5): 511-517.
10. Ueda Y, Shiozaki A, Itoi H, et al. Intraoperative pathological investigation of recurrent nerve nodal metastasis can guide the decision whether to perform cervical lymph node dissection in thoracic esophageal cancer. Oncol Rep, 2006, 16(5): 1061-1066.
11. 翁军玲, 田辉, 李鲁波. 食管癌患者胸内喉返神经旁淋巴结转移与颈部淋巴结的关联性. 世界华人消化杂志, 2016, 24(16): 2537-2542.
12. Tachimori Y, Nagai Y, Kanamori N, et al. Pattern of lymph node metastases of esophageal squamous cell carcinoma based on the anatomical lymphatic drainage system. Dis Esophagus, 2011, 24(1): 33-38.
13. Shang QX, Chen LQ, Hu WP, et al. Three-field lymph node dissection in treating the esophageal cancer. J Thorac Dis, 2016, 8(10): E1136-E1149.
14. 段孝凤, 高晓旭, 顾宪文. 序贯三切口及选择性淋巴结清扫治疗食管癌1162例临床效果分析. 肿瘤研究与临床, 2014, 26(6): 381-385.
15. 沈国义, 张文山, 张奕, 等. 术中胸内喉返神经旁淋巴结冰冻在指导胸段食管鳞癌三野淋巴结清扫的意义. 福建医科大学学报, 2017, 51(4): 240-244.
16. 朱德奇, 李春霖, 王忠民, 等. PT_1-3N₀M₀胸段食管鳞癌术后颈部淋巴结转移危险因素分析. 中国实验诊断学, 2019, 23(4): 623-625.
17. Shao L, Ye T, Ma L, et al. Three-field versus two-field lymph node dissection for thoracic esophageal squamous cell carcinoma: a propensity score-matched comparison. J Thorac Dis, 2018, 10(5): 2924-2932.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical analysis of the predictive value of recurrent laryngeal nerve lymph nodes status for supraclavicular lymph node metastasis in esophageal squamous cell carcinoma

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