食管淋巴结.ppt

Pattern of lymph node metastasis in patients with squamous cell carcinoma of the thoracic esophagus Hecheng Li, MD Ph.D. Jiaqing Xiang, MD, Yawei Zhang, MD Ph.D. Cancer Hospital of Fudan University, Shanghai, China Background Lymph node status is important in esophageal cancer Regional LNs: Periesophageal; subcarinal; mediastinal; perigastric Surgical resection is the standard treatment for early esophageal cancer Role of 3-F lymph node dissection Three field dissection for esophageal cancer has been practiced since the early 1980`s Advantages: Best way for lymph node dissection Decrease local recurrence Accurate information for staging Offer patients survival benefit Disadvantages: Morbidity and mortality were increased Negative reports with regard to survival benefit Objectives To study the pattern of lymph node metastasis in patients Analyze the relationship between tumor location and LN metastatic sites Find factors predicting LN status We aim to perform 3-FLD individually for patients so that morbidity and mortality could be decreased Patients Information Patients recruited between Jan. 2001 and Jan. 2005 All patients from Cancer Hospital of Fudan University Included criteria: With pathologically confirmed squamous carcinoma Medically fit for thoracic surgery Resetectable disease(T1-3 and resectable T4) No distant metastasis Surgical treatment: 3-FLD Excluded criteria: preoperative chemotherapy and/or radiotherapy 230 patients were included in the current analysis Demographic and clinicopathological data of patients Lymph node grouping Cervical nodes: No.104 and Nos.101; Thoracic nodes: 106rec, Nos. 105, 108, and 110, Nos. 107, 109, and 106tb,Nos. 111 and 112; Abdominal nodes: Nos. 1, 2, 3, 7, 8. Statistical analysis Chi-square: The metastatic sites of lymph nodes were correlated with tumor location Logistic regression: The relationship between clinical and pathological factors and lymph node metastasis SPSS 11.0 software program (SPSS Inc., Chi