Correlations between Extranodal Metastasis and Prognosis in Patients with Squamous Cell Carcinoma of the Esophagus

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Background Extranodal metastasis (EM) has been reported in carcinomas of many organs. However, the clinicopathological significance of EM in squamous cell carcinoma of the esophagus remains unclear, and this study sought to clarify this issue. Methods This study included 220 patients who underwent an esophagectomy with lymphadenectomy for primary esophageal carcinoma from 1996 to 2008. EM was defined as the presence of cancer cells in the soft tissue that were discontinuous with the primary lesion, or in the perinodal soft tissue distinct from the lymph nodes. Results EM was detected in 25 (9.6%) of the 220 patients, and in 56 (0.7%) of the 8,186 nodules retrieved as 'lymph nodes'. The incidence of EM was significantly higher in patients who had tumors of a larger size (diameter ≥ 4 cm), lymphatic vessel invasion, lymph node metastasis, a high pathological stage, infiltrative growth pattern, or a high pT-stage. The 5-year overall survival rates in N0-1 patients with EM were significantly lower than in the patients without EM (P = 0.005). Conclusion EM is closely associated with the development and aggressiveness of esophageal carcinoma, and the presence of EM can be useful for predicting prognosis after surgery in N0-1esophageal carcinoma patients.
昭和大学学士会の論文