Characteristics and clinical significance of recurrent laryngeal nerve lymph node metastasis in esophageal squamous cell carcinoma

Purpose: The recurrent laryngeal nerve lymph nodes (RLN LNs) are among the most common metastatic sites in esophageal cancer, and the dissection of these lymph nodes (LNs) is considered beneficial. The purpose of this study was to evaluate the characteristics of RLN LN metastases from esophageal squamous cell carcinoma, and the effects of these metastases on the prognosis of patients. In addition, we aimed to determine the reasonable range of dissection of regional LNs. Methods: The clinical data from 348 patients who underwent resection for esophageal carcinoma were retrospectively analyzed. Results: Recurrent laryngeal nerve palsy occurred in 37.6% of the patients. In a subgroup of patients with lower esophageal tumors, cervical LN metastases were significantly more common in patients with positive rather than negative RLN LNs. The primary tumor site, tumor differentiation, and tumor invasion depth were factors that significantly influenced RLN LN metastasis. Multivariate analysis revealed that RLN LN metastasis was a significant factor associated with overall survival (OS) and disease-free survival (DFS) (p<0.001). Conclusion: Metastasis to RLN LNs is a reliable indicator of cervical LN metastasis in middle/lower thoracic esophageal cancer. RLN LN metastasis may act as a prognostic indicator for patients with esophageal squamous cell carcinoma.