The prognostic significance of lymph node micrometastasis in patients with esophageal carcinoma

✍ Scribed by Raffaello Incarbone; Luigi Bonavina

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 47 KB
• Volume: 86
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/(sici)1097-0142(19991101)86:9<1883::aid-cncr33>3.0.co;2-d

✦ Synopsis

W e recently read the article by Glickman et al. regarding the prognostic significance of lymph node micrometastasis in esophageal carcinoma patients. 1 Indeed, it addresses a very interesting topic, and we would like to make a few observations. First, as stated in the article, the surgical procedure was associated "with extensive sampling of mediastinal and proximal gastric lymph nodes"; a mean of 6.9 Ϯ 4.1 lymph nodes (LNs) were removed per patient with esophageal adenocarcinoma and 8 Ϯ 3.9 per patient with squamous cell carcinoma. In a recent Consensus Conference on esophageal carcinoma, 2 it was suggested that at least 15 LNs have to be removed and submitted to the pathologist in order to achieve accurate staging of the disease; in fact, in the article, only 13%, 31%, and 63% of the patients with T1, T2, and T3 adenocarcinoma, respectively, had Nϩ, whereas in large series reported in the literature the rate of Nϩ for T1, T2, and T3 patients was 18 -20%, 58 -77%, and 82-84%, respectively; 3,4 therefore, some