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Therapeutic strategy for esophageal cancer based on solitary lymph node metastasis.

BACKGROUND/AIMS
It is essential to perform appropriate lymph node dissection in esophageal cancer. However, it may be beneficial if lymph node dissection could be minimized to reduce the surgical stress.


METHODOLOGY
Between April 1992 and March 2005, 121 esophageal cancer patients (42 patients with solitary lymph node metastasis and 79 N0 patients) were enrolled. The survival time, distribution of solitary lymph node metastasis and the pattern of recurrence were evaluated.


RESULTS
The distribution of solitary lymph node metastasis was extensively observed in cervical, thoracic and abdominal cavities and the site of lymph node recurrence could even be detected in non-regional lymph nodes in N0 patients. It was difficult to predict the site of initial lymph node metastasis in patients with esophageal cancer.


CONCLUSIONS
Systemic lymph node dissection for regional lymph nodes is recommended for resectable esophageal cancer as the concept of sentinel lymph nodes has not yet been proven.