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. 2024 Mar 18;86(5):2518-2523.
doi: 10.1097/MS9.0000000000001955. eCollection 2024 May.

Effect of cervical paraesophageal lymph node metastasis versus supraclavicular lymph node metastasis on the overall survival of patients with thoracic esophageal squamous cell carcinoma: an observational study

Kexun Li  1 , Changding Li  1 , Simiao Lu  1 , Wenwu He  1 , Chenghao Wang  1 , Yongtao Han  1 , Xuefeng Leng  1 , Lin Peng  1
Affiliations

Effect of cervical paraesophageal lymph node metastasis versus supraclavicular lymph node metastasis on the overall survival of patients with thoracic esophageal squamous cell carcinoma: an observational study

Kexun Li et al. Ann Med Surg (Lond). .

Abstract

Background: Esophageal cancer (EC) is a major global health burden, with a particularly high incidence in East Asia. The authors aimed to investigate the effect of metastasis in cervical paraesophageal lymph nodes (station 101) and supraclavicular lymph nodes (station 104) on the survival of patients who underwent esophagectomy for esophageal squamous cell carcinoma (ESCC).

Materials and methods: Data were obtained from the database of the authors' hospital. The authors retrospectively analyzed the patients with EC who underwent esophagectomy from January 2010 to December 2017. These patients were allocated into two groups based on the presence of lymph node metastasis (LNM) in the cervical paraesophageal or supraclavicular regions. Clinical outcomes and survival data were compared using the TNM staging system of the 8th edition of the American Joint Committee on Cancer (AJCC).

Results: After a median follow-up of 62.1 months, 122 patients with LNM in the supraclavicular region were included in the study. Among these patients, 53 showed cervical paraesophageal LNM and an overall survival (OS) of 19.9 months [95% confidence interval (CI): 16.3-23.5]. In contrast, 69 patients showed supraclavicular LNM with an OS of 34.9 months (95% CI 25.7-44.1). The OS rates at 1, 3, and 5 years were 77%, 29%, and 21%, respectively, for patients with cervical paraesophageal LNM. Moreover, patients with supraclavicular LNM demonstrated OS rates of 88%, 48%, and 34%, respectively [Hazard ratio (HR): 0.634, 95% CI: 0.402-1.000, P=0.042].

Conclusions: Patients with ESCC with cervical paraesophageal LNM had significantly worse OS than those with supraclavicular LNM. This study underscores the importance of accurately identifying and managing ESCC with cervical paraesophageal LNM, as it may require more tailored and aggressive treatment strategies to prolong patient survival.

Keywords: cervical paraesophageal lymph node metastasis; esophageal squamous cell carcinoma; esophagectomy; lymphadenectomy; supraclavicular lymph node metastasis.

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Conflict of interest statement

The authors have no conflicts of interest to declare.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
CONSORT diagram showing the process of patient selection. LNM, lymph node metastasis; TESCC, thoracic esophageal squamous cell carcinoma.
Figure 2
Figure 2
OS analysis of patients with cervical paraesophageal LNM and supraclavicular LNM.
See this image and copyright information in PMC

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