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Background <p>According to the results of JCOG0502, esophagectomy and chemoradiotherapy are standard treatments for cT1bN0M0 esophageal squamous cell carcinoma (ESCC). In the trial, 27.0% of patients developed pathological lymph node metastases (LNM). As imaging has advanced, diagnostic accuracy may have improved as well. This supplementary analysis of JCOG1409 aimed to clarify the clinical diagnostic accuracy, including the lymph node metastasis-positive proportion and lymph node metastasis sites, for clinical T1bN0M0 ESCC.</p> Methods <p>Data from JCOG1409, which compared thoracoscopic and open esophagectomy for ESCC, were analyzed, focusing on patients with cT1bN0M0 disease. All patients underwent esophagectomy with D2 or greater lymph node dissection, and none received neoadjuvant treatment. Pathologic findings, including the pathologic tumor depth of the primary tumor, station, and frequencies of LNM, were assessed.</p> Results <p>A total of 89 patients were included in this analysis. The diagnosis of pT1b was 66.3% (59/89 patients). For N-stage accuracy, 17 (19.1%) of the 89 clinical N0 patients had pathologic LNM. LNM was confined to the cervical and upper mediastinal regions in upper thoracic tumors, and to the upper mediastinal and abdominal regions in lower thoracic tumors. Conversely, middle thoracic tumors exhibited widespread multi-field LNM.</p> Conclusion <p>The clinical diagnosis of T1bN0M0 is still not accurate, although the diagnostic accuracy for LNM in JCOG1409 improved compared to that in JCOG0502.</p>

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Clinical diagnostic accuracy and lymph node metastasis patterns in clinical T1bN0M0 esophageal squamous cell carcinoma: a supplementary analysis of JCOG1409

  • 期刊论文

  • 发表日期：

    2026年7月7日

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  • Motoo Nomura,
  • Hiroya Takeuchi,
  • Masahiko Ando,
  • Yasuhiro Tsubosa,
  • Hirotoshi Kikuchi,
  • Hirofumi Kawakubo,
  • Kazuhiro Noma,
  • Masaki Ueno,
  • Takahiro Tsushima,
  • Takeo Bamba,
  • Takeo Fujita,
  • Yoichi Hamai,
  • Tomokazu Kakishita,
  • Hiroyuki Daiko,
  • Kazuo Koyanagi,
  • Satoru Matsuda,
  • Ken Kato,
  • Keita Sasaki,
  • Tetsuya Sekita,
  • Ryunosuke Machida,
  • Yuko Kitagawa

摘要

Background

According to the results of JCOG0502, esophagectomy and chemoradiotherapy are standard treatments for cT1bN0M0 esophageal squamous cell carcinoma (ESCC). In the trial, 27.0% of patients developed pathological lymph node metastases (LNM). As imaging has advanced, diagnostic accuracy may have improved as well. This supplementary analysis of JCOG1409 aimed to clarify the clinical diagnostic accuracy, including the lymph node metastasis-positive proportion and lymph node metastasis sites, for clinical T1bN0M0 ESCC.

Methods

Data from JCOG1409, which compared thoracoscopic and open esophagectomy for ESCC, were analyzed, focusing on patients with cT1bN0M0 disease. All patients underwent esophagectomy with D2 or greater lymph node dissection, and none received neoadjuvant treatment. Pathologic findings, including the pathologic tumor depth of the primary tumor, station, and frequencies of LNM, were assessed.

Results

A total of 89 patients were included in this analysis. The diagnosis of pT1b was 66.3% (59/89 patients). For N-stage accuracy, 17 (19.1%) of the 89 clinical N0 patients had pathologic LNM. LNM was confined to the cervical and upper mediastinal regions in upper thoracic tumors, and to the upper mediastinal and abdominal regions in lower thoracic tumors. Conversely, middle thoracic tumors exhibited widespread multi-field LNM.

Conclusion

The clinical diagnosis of T1bN0M0 is still not accurate, although the diagnostic accuracy for LNM in JCOG1409 improved compared to that in JCOG0502.