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Review

Lymph node classification of esophageal squamous cell carcinoma and adenocarcinoma

Digestive Surgery, Department of Surgery, Faculty of Medicine, Shimane University, Izumo 693-8501, Shimane, Japan

Received 30 December 2007; received in revised form 17 April 2008; accepted 21 April 2008.

^_* Corresponding author. Tel.: +81 853 20 2232; fax: +81 853 20 2229. (Email: surgery{at}hc-hosp.or.jp).

The lymphatic channels of the esophagus run vertically along the axis of the esophagus and some of them drain into the cervical lymph glands upwards and into the abdominal glands downwards, and the pattern of lymph node metastasis of esophageal carcinoma is widespread. In various classifications of pattern of lymphatic spread, four classifications were proposed; location, number, ratio, and size. No definite survival advantage of aggressive lymph node dissection during esophagectomy has been proved compared with less dissection. Stage migration, micrometastasis, and sentinel lymph node concept all make it possible to individualize surgical management of esophageal carcinoma as a part of various multimodal treatments. Early diagnosis, standardization of surgery including routine lymph node dissection, and perioperative management of patients have all led to better survival rates of esophageal carcinoma.

Key Words: Esophageal cancer • Lymph node metastasis • Lymphadenectomy • Lymph node dissection