OBJECTIVE: To assess prognosis according to whether lymph node involvement is intracapsular or with extracapsular breakthrough in @entity420 of the distal esophagus and gastroesophageal junction. Materials and methods One hundred ninety-five consecutive @entity1 with T3 @entity420 of the distal esophagus and gastroesophageal junction between 1990 and 1999 were studied. All @entity1 underwent primary R0 esophagectomy. The mean number of resected nodes per @entity1 was 36.9. Survival was analyzed according to intracapsular and extracapsular involvement. RESULTS: In N0 @entity1 5-year survival was 57% and 9-year survival was 38.7%. In @entity1 with positive nodes these figures were 26.2% and 18.1%, respectively (P =.0069). Intracapsular and extracapsular node involvement showed 5- and 10-year survival of 40.9% and 21.7% versus 18% and 15.7%, respectively. There was no significant difference in 5- and 10-year survival between N0 and intracapsular node involvement (P =.43). However, there was a significant difference in survival between N0 and extracapsular node involvement (P =.002) and between intracapsular and extracapsular node involvement (P =.0001). CONCLUSIONS: This study shows a significant difference in survival according to whether lymph node involvement was intracapsular or extracapsular. @entity1 with intracapsular lymph node involvement have similar survival rates as N0 @entity1 . Extracapsular lymph node involvement is a bad prognostic factor, independent of the number of involved lymph nodes. The number of involved lymph nodes has an additive negative effect. These data may have an impact on treatment strategies.

Extracapsular lymph node involvement is a negative prognostic factor in T3 XXXX of the distal esophagus and gastroesophageal junction.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'Patients'] @entity420 :: ('MESH:D000230', 'Disease') :: ['adenocarcinoma']
@entity420 :: (MESH:D000230,Disease) :: ['adenocarcinoma']
