Background: Compared to other hollow viscus organs, the oesophagus has a unique anatomy in which lymphatic channels are abundantly present in the mucosa and submucosa. It has been hypothesized that tumour cells can directly disseminate from these superficial layers into the thoracic duct without passing juxta-tumoral lymph nodes. We investigated whether tumour cells of an oesophageal carcinoma could be detected in the thoracic duct during operative manipulation.
Methods: In patients with an adenocarcinoma of the oesophagus and/or gastro-oesophageal junction, undergoing a transthoracic resection with two-field lymphadenectomy, lymph was collected and cells were immunostained.
Results: Tumour cells could be detected in the thoracic duct lymph of only 1 out of 19 patients during operative manipulation.
Conclusion: Peroperative data from this study do not support the hypothesis that oesophageal carcinoma readily metastasizes directly into the thoracic duct.
Copyright 2001 S. Karger AG, Basel