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Endoscopy 2004; 36(11): 961-965
DOI: 10.1055/s-2004-825960
Original Article
© Georg Thieme Verlag Stuttgart · New York

Outcome of Patients with Esophageal Carcinoma and Suspicious Celiac Lymph Nodes as Determined by Endoscopic Ultrasonography

W.  A.  Marsman1, 2 , M.  van Wissen1, 2 , J.  J.  G.  H.  M.  Bergman1 , J.  J.  B.  van Lanschot2 , H.  Obertop2 , G.  N.  J.  Tytgat1 , P.  Fockens1
  • 1Department of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands
  • 2Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands
Further Information

Publication History

Submitted 10 March 2004

Accepted after Revision 27 July 2004

Publication Date:
02 November 2004 (online)

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Background and Study Aims: The management of patients with esophageal cancer with malignant celiac lymph nodes (CLNs) is controversial. In this study we evaluated the management and survival of patients with positive CLN findings on endoscopic ultrasonography (EUS) and compared the outcome in surgically treated patients with that of nonsurgically treated patients.
Patients and Methods: The EUS database of the Academic Medical Center was retrospectively searched for patients with esophageal carcinoma and EUS-positive CLN. Follow-up comprised the review of medical charts and contact with general practitioners.
Results: From 1993 through 2000, 78 patients with esophageal carcinoma and suspicious CLN were eligible for inclusion in this study. The median survival of patients with CLN size < 2 cm was 13.5 months vs. 7.0 months for patients with CLN size >2 cm (P = 0.01). In a multivariate model, CLN size was the only predictive factor for poor patient survival. Of the 78 study patients, 13 underwent a surgical resection and 65 received nonsurgical treatment. The surgical group was significantly younger and all patients in this group had CLN size < 2 cm. The median survival for the surgical group was 13.7 months vs. 13.5 months for the nonsurgical group with CLN size < 2 cm (P = 0.63).
Conclusions: In this retrospective study, CLN size was a significant predictor for poor survival. The surgically treated patients had a medium-term survival similar to that of nonsurgically treated patients with a CLN size < 2 cm. These findings underline the prognostic value of CLN size in patients with esophageal carcinoma.

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W. A. Marsman, M. D.

Department of Experimental Hepatology, Academic Medical Center

Meibergdreef 9 · 1105 AZ Amsterdam · The Netherlands

Fax: +31-20-5669190

Email: w.a.marsman@amc.uva.nl

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