Abstract:
Objective To investigate characteristics and risk factors of lymph node metastasis in synchronous multiple primary esophageal squamous cell carcinoma.
Methods Data of 56 patients with synchronous multiple primary esophageal squamous cell carcinoma who underwent surgery in Tianjin Medical University Cancer Institute & Hospital, during a period from January 2011 to December 2018, were collected. The lymph node metastasis rate at different sites was retrospectively analyzed. The depth of tumor infiltration, tumor length at different sites and other factors were analyzed to assess their influences on lymph node metastasis.
Results Of the total 56 patients with synchronous multiple primary esophageal squamous cell carcinoma, 34 suffered from lymph node metastasis, and the total nodal metastasis rate was 60.7%. And the lymph node metastasis rates in cervical, upper mediastinum, lower mediastinum and abdomen were 16.7%, 34.7%, 32.7% and 38.2%, respectively. The lymph node metastasis patterns varied based on different cancer sites. But lymph node metastasis was always observed in the areas of upper mediastinum, lower mediastinum and along with the abdomen. The results from univariate analysis showed that the lymph node metastasis was associated with length of the tumor and depth of infiltration at each tumor site (P < 0.05). The results from multivariate analysis showed that the depth of tumor infiltration at the primary tumor site and harvested lymph node numbers were the independent prognostic factors for the nodal metastasis.
Conclusions McKeown resection with systematic lymph node dissection is the best option for treating synchronous multiple primary esophageal squamous cell carcinoma.