Abstract
Lymph node(LN)metastasis is a common metastasis mode of esophageal squamous cell carcinoma (ESCC). The purpose of this study is to explore whether recurrent laryngeal nerve LNs metastasis can be used as a predictor of cervical LN dissection.
Methods
The postoperative pathological examination results of patients with ESCC who underwent three-field LN dissection in Sichuan Cancer Hospital from January 2010 to January 2016 were retrospectively collected to explore the relationship between the recurrent laryngeal nerve LN metastasis and cervical LN metastasis. At the same time, analyzed survival data to determine whether cervical LN dissection should be performed on patients with thoracic ESCC.
Results
Among all the study subjects, 53.3% (72/135) patients had metastasis in the thoracic recurrent laryngeal nerve LNs, and 36.3% (49/135) patients had metastasis in the cervical LN. 44.4% (32/72) Patients with metastasis in the thoracic recurrent laryngeal nerve LN tended to have a high incidence of cervical LN metastasis (P = 0.035). Subgroup analysis showed that 60% (81/135) patients had upper thoracic ESCC, and 46.9% (38/81) patients had cervical LN metastasis (P = 0.002). Survival analysis showed that patients with cervical LN metastasis had poor survival (P < 0.001). Multivariate analysis showed that bilateral recurrent laryngeal nerve LN metastasis was an independent risk factor for survial(P = 0.029).
Conclusion
Patients with bilateral recurrent laryngeal nerve LN metastasis in upper thoracic ESCC can be used as a predictor of cervical LN dissection.
Safety and oncological efficacy of bilateral recurrent laryngeal nerve lymph-node dissection after neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma: a propensity-matched analysis