Lymphatic spreading and lymphadenectomy for esophageal carcinoma

doi:10.4240/wjgs.v8.i1.90

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World Journal of Gastrointestinal Surgery

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World J Gastrointest Surg. Jan 27, 2016; 8(1): 90-94
Published online Jan 27, 2016. doi: 10.4240/wjgs.v8.i1.90

Lymphatic spreading and lymphadenectomy for esophageal carcinoma

Xiang Ji, Jie Cai, Yao Chen, Long-Qi Chen

Xiang Ji, Jie Cai, Yao Chen, Long-Qi Chen, Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China

Author contributions: Cai J and Chen Y performed the literature search; Chen LQ suggested the theme to be reviewed, designed the text structure and made several critical corrections; Ji X performed the literature search, wrote the text and made revisions until the submitted version was achieved.

Conflict-of-interest statement: The above-mentioned authors of this manuscript hereby declare that they do not have any conflict of interest (including but not limited to commercial, personal, political, intellectual or religious interests) related to this work.

Correspondence to: Dr. Long-Qi Chen, Department of Thoracic Surgery, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Wuhou District, Chengdu 610041, Sichuan Province, China. drchenlq@gmail.com

Telephone: +86-28-85422494 Fax: +86-28-85422494

Received: June 29, 2015
Peer-review started: July 3, 2015
First decision: August 25, 2015
Revised: October 6, 2015
Accepted: December 1, 2015
Article in press: December 2, 2015
Published online: January 27, 2016
Processing time: 206 Days and 1.5 Hours

Abstract

Esophageal carcinoma (EC) is a highly lethal malignancy with a poor prognosis. One of the most important prognostic factors in EC is lymph node status. Therefore, lymphadenectomy has been recognized as a key that influences the outcome of surgical treatment for EC. However, the lymphatic drainage system of the esophagus, including an abundant lymph-capillary network in the lamina propria and muscularis mucosa, is very complex with cervical, mediastinal and celiac node spreading. The extent of lymphadenectomy for EC has always been controversial because of the very complex pattern of lymph node spreading. In this article, published literature regarding lymphatic spreading was reviewed and the current lymphadenectomy trends for EC are discussed.

Keywords: Lymphadenectomy; Lymphatic spreading; Anatomical lymphatic system; Lymph node metastasis; Esophageal cancer

Core tip: Esophageal carcinoma (EC) is a highly lethal malignancy with a poor prognosis. One of the most important prognostic factors in EC is lymph node status. Therefore, lymphadenectomy has been recognized as a key that influences the outcome of surgical treatment for EC. However, the lymphatic drainage system of the esophagus is very complex, with cervical, mediastinal and celiac node spreading. The extent of lymphadenectomy for EC has always been controversial because of the very complex pattern of lymph node spreading. In this article, published literature regarding lymphatic spreading was reviewed and the current lymphadenectomy trends for EC are discussed.