Study on prognostic significance of lymph node metastasis in carcinoma of thoracic esophagus

Objective To explore the effect of number of positive lymph nodes on survival in patients with esophageal carcinoma,and to evaluate the influence factors of positive lymph nodes number.Methods From October 1996 to August 2000,a total of 2807 resected lymph nodes were obtained from 282 patients who underwent curative resection of the primary tumour with systematic lymphadenectomy at Shanxi Cancer Hospital.The survivals were analysed by life tables and Kaplan-Meier methods,the related factors of lymph node metastasis were assessed by Chi-square test.Results 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.The number of positive lymph nodes was negative related to survival rates in carcinoma of thoracic esophagus.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 esophagus.The risk of the number of positive lymph node metastasis was significantly influenced by length,histologic grade,circumference and lymphangial tumor-cells thrombus.Conclusion The number of positive lymph node can better reflect the prognosis of patients.The authors suggested a modification of the tu- mor-lymph node-metastasis(TNM)staging classification(ypTNM)to include the number of positive lymph nodes in the ypN1 category.