Significance of Supraclavicular Lymph Node Involvement on Determination of Clinical Staging for Thoracic Esophageal Carcinoma

摘要

BACKGROUND AND PURPOSE: Involvement of supraclavicular lymph nodes (SCL) is considered distant metastasis for thoracic esophageal carcinoma in AJCC staging system revised in 1997. We investigated significance of SCL involvement compared to other regional lymph node involvement. MATERIALS AND METHODS: Two-hundred eighty-nine patients with unresectable esophageal carcinoma were treated with radiation therapy from June of 1979 through December 1992. Of these patients, 25 were identified having SCL involvement. Survival rate and relapse patterns were compared with that of mediastinal and perigastric lymph node positive patients to evaluate prognostic significance of SCL involvement. RESULTS: Median survival for patients with SCL involvement was 7 months and 2- and 5-year overall survival rates were 12.0% and 4.0% respectably. Corresponding features for regional node positive patients were 9 month, 17.0% and 3.8%. There was no significant difference between two groups. There was also no difference in patterns of recurrence. CONCLUSION: Results of this analysis showed that SCL involvement should be staged as nodal disease in contrast to present classification of metastatic disease.