Impact of solitary involved lymph node on outcome in localized cancer of the esophagus and esophagogastric junction

Abstract

Node-positive esophageal cancer is associated with a dismal prognosis. The impact of a solitary involved node, however, is unclear, and this study examined the implications of a solitary node compared with greater nodal involvement and node-negative disease. The clinical and pathologic details of 604 patients were entered prospectively into a database from1993 and 2005. Four pathologic groups were analyzed: node-negative, one lymph node positive, two or three lymph nodes positive, and greater than three lymph nodes positive. Three hundred and fifteen patients (52%) were node-positive and 289 were node-negative. The median survival was 26 months in the node-negative group. Patients (n∈=∈84) who had one node positive had a median survival of 16 months (p∈=∈0.03 vs node-negative). Eighty-four patients who had two or three nodes positive had a median survival of 11 months compared with a median survival of 8 months in the 146 patients who had greater than three nodes positive (p∈=∈0.01). The survival of patients with one node positive [number of nodes (N)∈=∈1] was also significantly greater than the survival of patients with 2-3 nodes positive (N∈=∈2-3) (p∈=∈0.049) and greater than three nodes positive (p∈