Association of location of lymph node metastases with postoperative recurrence of esophageal squamous cell carcinoma.

Lymph node (LN) metastasis in patients with esophageal squamous cell carcinoma (ESCC) has important prognostic implications. In this study, we examined the association between postoperative recurrence and the location of LN metastases in patients with clinical stage II/III ESCC. Of 90 patients who underwent curative esophagectomy with systemic lymphadenectomy at our Department between 2000 and 2007, we identified 49 recurrences and 37 deaths during follow-up. UICC pathological stage, pathological intramural metastasis, total number of LN metastases, and number of involved LNs in upper paraesophageal, subcarinal, lower paraesophageal, post mediastinal, perigastric, and celiac locations were significantly associated with recurrence-free survival (RFS) in univariate analysis. In multivariate analysis, the number of involved subcarinal and lower paraesophageal LNs were independent factors predictive of postoperative recurrence. Our findings suggest that patients with LN metastases at these locations are at risk of recurrence and should be considered for more aggressive adjuvant therapies.