Lymph node and perinodal tissue tumor involvement in patients with esophagectomy and three-field lymphadenectomy for carcinoma of the esophagus

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Abstract
Background Lymph node metastasis is a definitive prognostic factor; however, perinodal fat tumor invasion has not been fully elucidated. Methods Periesophageal nodes and the surrounding fibrofatty tissue obtained from 131 patients who underwent esophagectomy were examined. Results Of 9,789 nodes removed, 645 (6.6%) demonstrated invasion and 143 (1.5%) showed perinodal involvement. Of 131 patients, 97 (74.0%) had lymph node involvement and 43 (32.8%) had perinodal fat involvement. The incidence of perinodal tissue involvement correlated significantly with the number of nodes involved; 23 (42.6%) of 54 patients with a total of 1–8 nodes involved and 19 (95.0%) of 20 patients with 9 or more involved nodes had perinodal involvement. The 5‐year survival for 33 patients without involved nodes or perinodal tissue extension was 59.7%, compared to 14.0% for 43 patients with perinodal fat involvement. Conclusion Perinodal tissue carcinoma into the periesophageal fibrotatty tissue was a decisive prognostic factor in patients with curative resection for esophageal carcinoma. J. Surg. Oncol. 64:12–16