Histopathological Study and Pattern of Lymph Node Involvement in Carcinoma Esophagus: A Tertiary Care Centre Experience from Northern India


  • Sanjeev Parshad
  • Sushil Kumar
  • Ravinder Kumar
  • Kapil Kadian




Carcinoma esophagus, squamous cell carcinoma, Mediastinal lymph nodes


Background: Esophageal cancer remains one of the deadliest cancers with an overall 5-year survival
rate estimated to be less than 18%. Squamous cell carcinoma of the esophagus is the predominant
histology in the cervical esophagus and upper and middle thirds of the thoracic esophagus, whereas
adenocarcinoma predominates in the distal esophagus. Lymph node involvement and the number of
lymph node metastases are important prognostic factors
Materials and Methods: 30 patients of mid and lower thoracic esophageal carcinoma treated between
2008 to 2014 were studied retrospectively. Histopathological profiles were analysed mainly in terms of
pattern of lymph node involvement.
Results: 26 cases were squamous cell carcinoma and 3 were adenocarcinoma while 1 case was
pathological complete response after neoadjuvant treatment. 22/30 were moderately differentiated.
24/30 had lymph node involvement where T3N1 was the commonest stage as 50% had achieved this
stage. Mediastinal group of lymph nodes were involved in 23 cases upper abdominal lymph nodes
were involved only in 1 case while cervical lymph nodes were not involved in any case. Among
mediastinal group paraesophageal, paratracheal lymph node involvement was the commonest followed
by subcarinal and recurrent laryngeal group of lymph nodes.
Conclusion: Squamous cell carcinoma is still the commonest variety prevailing in this region. Majority
of the cases present in advanced stage with lymph node involvement. Mediastinal group of lymph nodes
are involved in majority of the cases hence precise clearance of this group is of utmost importance to
prevent local recurrence and prolonged survival.

Author Biographies

Sanjeev Parshad

Professor, Department of General Surgery,  Pt B D Sharma PGIMS Rohtak

Sushil Kumar

Assistant Professor, Department of Surgical Oncology,Pt B D Sharma PGIMS Rohtak

Ravinder Kumar

Senior Resident, Department of General Surgery, Pt B D Sharma PGIMS Rohtak

Kapil Kadian

Senior Resident, Department of General Surgery, Pt B D Sharma PGIMS Rohtak