Objective: To investigate the status of lymph node metastases (LNM) of esophageal carcinoma and to identify the risk factors.
Methods: 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.
Results: 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.
Conclusions: 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.
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