Abstract
Background
The distribution of mediastinal lymph node involvement is not clear in patients with adenocarcinoma of the esophagogastric junction (AEG). Based on our experiences with radical lymphadenectomy of upper mediastinum for esophageal squamous cell carcinoma, we applied this technique to patients with AEG. We retrospectively investigated it and compared it with that in patients who had lower esophageal squamous cell carcinoma (ESCC) with clinical invasion of the esophagogastric junction.
Methods
Sixty-four patients underwent esophagectomy via a right thoracotomy or a minimally invasive esophagectomy for Siewert type I tumor or type II with ≥ 3 cm esophageal invasion. The incidences of mediastinal lymph node involvements and the characteristics of patients with mediastinal nodal involvement were analyzed retrospectively. In addition, these outcomes were compared with 72 patients who had lower ESCC with clinical invasion of the esophagogastric junction.
Results
In 64 patients with AEG, mediastinal lymph node involvement was seen in 23 patients (36%). The incidences of upper, middle, lower mediastinal nodal involvement were 19%, 16%, and 22%, respectively. No significant differences were found for cStage, Siewert type, endoscopic tumor length, pT or pN status, residual tumor, or survival between patients with upper nodal involvement and those with middle or lower nodal involvement. The incidence of each mediastinal lymph node involvement was similar between AEG and lower ESCC patients.
Conclusion
Although our outcomes were based on limited data, the incidence of upper, middle, and lower mediastinal lymph node involvement might not be low, and its clinical characteristics were similar to those for middle or lower mediastinal nodal involvement in esophageal adenocarcinoma.
Disclosure
All authors have declared no conflicts of interest.
Clinicopathological Factors Associated with Unexpected N3 in Patients with Mediastinal Lymph Node Involvement
