Study On Prognositic Signnificance Of Lymph Node Metastasis In Carcinoma Of Thoracic Esophageal

Objective: Esophageal adenocarcinoma is an aggressive neoplasm with poor prognosis as a result of early lymph node metastasis. The current pathological tumour node metastasis (pTNM) classification system does not consider the number of lymph nodes in the staging and classification scheme for patients with esophageal carcinoma. The author explored the effect of number of positive lymph nodes on survival in patients with esophageal carcinoma.And to evaluate influence factors of number of positive lymph nodes.Methords: From Octber 1996 through August 2000, a total of 2,807 resected lymph nodes were obtained from 282 patients who underwent curative resection of the primary tumour with systematic lymphadenectomy at the Shanxi cancer hospital,China. The survivals were analysed by life tables and Kaplan-Meier methods , the related factors of lymph node metastasis were assessed by Chi-square test.Result: (1) A total of 2807 lymph nodes were resected, positive lymph nodes 490,metastatic lymph node ratio was 17.46%(490/2807). (2) The 1- year, 3- year, and 5-year overall survival rates for all 282 patients were 73.76% , 37.69%, 24.04%, respectively.The median survival time was 1.91 years. The 1- year, 3- year, and 5-year survival for node-negative patients was 80.65%,50.12%,36.70%versus 65.35%,22.46%,7.94% for node-positive patients(P=0.0000 ).(3) The number of positive lymph nodes was negative related to survival rates in carcinoma of thoracic esophageal. According to the number of positive lymph node metastasis, there was significanct difference in survival among our suggesting grouping, group1: node-negative, group2:one to six nodes , group3:more than 3 nodes. he 1- year, 3- year, and 5-year overall survival rates were 81%,50%,36%;72%,27%,11%;49%,11%,0, respectively.(p<0.05)(4) The number of positive lymph nodes was positive related to metastatic lymph node ratio; Metastatic lymph node ratio, location of metastatic lymph node were not associated with survival rates in carcinoma of thoracic esophageal (5) The risk of the number of positive lymph node metastasis as significantly influenced by length,histologic grade,circumference and lymphangial tumor-cells thrombus(x2 =40.559 P=0.034;x2= 29.919 P=0.000;x2 =52.796 P=0.035;x2 =5.842 P=0.016,respectively)Conclusion: (1) The number of positive lymph nodes involvement was the most important prognostic factor in both classifications (2) The more lymph nodes were resected,the more positive lymph nodes were found. (3) The number of positive lymph node can better reflect the...