Objective: To study the extent of lymph node involvement in relation to survival of patients with thoracic esophageal carcinoma.
Methods: From 1990 to 1993, there were 112 patients with thoracic esophageal carcinoma undergone esophagectomy through right thoracotomy and three-field lymphadenectomy. They were classified into three groups: group A, 44 patients without lymph node involvement; group B, 36 patients with 1 to 3 positive nodes; group C, 32 patients with > or = 4 involved lymph nodes. Nine possible factors influencing survival were studied. A multivariate analysis of these variables was performed using the cumulative survival rate by the computer's Cox proportional hazard model.
Results: The over-all cumulative survival rate was 58.4% at 5 years. That for patients in group A, B and C was 88.4%, 50.8% and 20.8%, respectively. Apart from the extent of lymph node metastases, depth of tumor invasion, location and differentiation of tumor were of prognostic significance.
Conclusion: Lymph node metastasis is the major factor affecting survival of patients with cancer of the thoracic esophagus.