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Hagens ERC, van Berge Henegouwen MI, Gisbertz SS. Distribution of Lymph Node Metastases in Esophageal Carcinoma Patients Undergoing Upfront Surgery: A Systematic Review. Cancers (Basel). 2020;12(6)doi: 10.3390/cancers12061592.
Hagens, E. R. C., van Berge Henegouwen, M. I., & Gisbertz, S. S. (2020). Distribution of Lymph Node Metastases in Esophageal Carcinoma Patients Undergoing Upfront Surgery: A Systematic Review. Cancers, 12(6), . https://doi.org/10.3390/cancers12061592
Hagens, Eliza R C, et al. "Distribution of Lymph Node Metastases in Esophageal Carcinoma Patients Undergoing Upfront Surgery: A Systematic Review." Cancers vol. 12,6 (2020). doi: https://doi.org/10.3390/cancers12061592
Hagens ERC, van Berge Henegouwen MI, Gisbertz SS. Distribution of Lymph Node Metastases in Esophageal Carcinoma Patients Undergoing Upfront Surgery: A Systematic Review. Cancers (Basel). 2020 Jun 16;12(6). doi: 10.3390/cancers12061592. PMID: 32560226; PMCID: PMC7352338.
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Cancers (Basel). 2020 Jun 16;12(6). doi: 10.3390/cancers12061592.

Distribution of Lymph Node Metastases in Esophageal Carcinoma Patients Undergoing Upfront Surgery: A Systematic Review.

Cancers

Eliza R C Hagens, Mark I van Berge Henegouwen, Suzanne S Gisbertz

Affiliations

  1. Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Cancer Center Amsterdam, 1105AZ Amsterdam, The Netherlands.

PMID: 32560226 PMCID: PMC7352338 DOI: 10.3390/cancers12061592

Abstract

Metastatic lymphatic mapping in esophageal cancer is important to determine the optimal extent of the radiation field in case of neoadjuvant chemoradiotherapy and lymphadenectomy when esophagectomy is indicated. The objective of this review is to identify the distribution pattern of metastatic lymphatic spread in relation to histology, tumor location, and T-stage in patients with esophageal cancer. Embase and Medline databases were searched by two independent researchers. Studies were included if published before July 2019 and if a transthoracic esophagectomy with a complete 2- or 3-field lymphadenectomy was performed without neoadjuvant therapy. The prevalence of lymph node metastases was described per histologic subtype and primary tumor location. Fourteen studies were included in this review with a total of 8952 patients. We found that both squamous cell carcinoma and adenocarcinoma metastasize to cervical, thoracic, and abdominal lymph node stations, regardless of the primary tumor location. In patients with an upper, middle, and lower thoracic squamous cell carcinoma, the lymph nodes along the right recurrent nerve are often affected (34%, 24% and 10%, respectively). Few studies describe the metastatic pattern of adenocarcinoma. The current literature is heterogeneous in the classification and reporting of lymph node metastases. This complicates evidence-based strategies in neoadjuvant and surgical treatment.

Keywords: esophageal cancer; esophagectomy; lymph node metastases; lymphadenectomy; systematic review

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