Histopathological Study and Pattern of Lymph Node Involvement in Carcinoma Esophagus: A Tertiary Care Centre Experience from Northern India

Background: Esophageal cancer remains one of the deadliest cancers with an overall 5-year survivalrate estimated to be less than 18%. Squamous cell carcinoma of the esophagus is the predominanthistology in the cervical esophagus and upper and middle thirds of the thoracic esophagus, whereasadenocarcinoma predominates in the distal esophagus. Lymph node involvement and the number oflymph node metastases are important prognostic factorsMaterials and Methods: 30 patients of mid and lower thoracic esophageal carcinoma treated between2008 to 2014 were studied retrospectively. Histopathological profiles were analysed mainly in terms ofpattern of lymph node involvement.Results: 26 cases were squamous cell carcinoma and 3 were adenocarcinoma while 1 case waspathological complete response after neoadjuvant treatment. 22/30 were moderately differentiated.24/30 had lymph node involvement where T3N1 was the commonest stage as 50% had achieved thisstage. Mediastinal group of lymph nodes were involved in 23 cases upper abdominal lymph nodeswere involved only in 1 case while cervical lymph nodes were not involved in any case. Amongmediastinal group paraesophageal, paratracheal lymph node involvement was the commonest followedby subcarinal and recurrent laryngeal group of lymph nodes.Conclusion: Squamous cell carcinoma is still the commonest variety prevailing in this region. Majorityof the cases present in advanced stage with lymph node involvement. Mediastinal group of lymph nodesare involved in majority of the cases hence precise clearance of this group is of utmost importance toprevent local recurrence and prolonged survival.