Appraisal of a Revised Lymph Node Classification System for Esophageal Squamous Cell Cancer Dipok Kumar Dhar, PhD, Shinji Hattori, MD, Yasuhito Tonomoto,

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Appraisal of a Revised Lymph Node Classification System for Esophageal Squamous Cell Cancer Dipok Kumar Dhar, PhD, Shinji Hattori, MD, Yasuhito Tonomoto, MD, Tadakazu Shimoda, PhD, Hoichi Kato, PhD, Mitsuo Tachibana, PhD, Kosho Matsuura, MD, Yojiro Mitsumoto, PhD, Alex G. Little, MD, Naofumi Nagasue, PhD The Annals of Thoracic Surgery Volume 83, Issue 4, Pages 1265-1272 (April 2007) DOI: 10.1016/j.athoracsur.2006.12.003 Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Distribution percentages of the largest metastatic lymph node location in relation to the site of the primary tumor: (A) upper, (B) middle, and (C) lower part of the thoracic esophagus. Lymph node locations are numbered according to the Japanese classification [22]. The Annals of Thoracic Surgery 2007 83, 1265-1272DOI: (10.1016/j.athoracsur.2006.12.003) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Disease-free survival according to our n-stage (A) and metastatic lymph node (MLN) ratio N-stage (B) are shown. The Annals of Thoracic Surgery 2007 83, 1265-1272DOI: (10.1016/j.athoracsur.2006.12.003) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Kaplan-Meier disease-free survival of patients when metastatic lymph node (MLN) size n-stage groups (A, B) and MLN ratio N-stage groups (C, D) were further stratified by the MLN size n-stage and MLN ratio N-stage, respectively. The Annals of Thoracic Surgery 2007 83, 1265-1272DOI: (10.1016/j.athoracsur.2006.12.003) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Disease-free survival curves according to the combined N-stage (A) (MLN ratio N-stage + MLN size n-stage) and (B) TNM stage incorporating the combined N-stage. In combined N-stage, patients with both n1 (MLN size n-stage) and N1 (MLN ratio N-stage) disease were considered to have N1 disease, patients with both n2 and N2 diseases as N3, and all others were grouped under the N2 stage. (MLN = metastatic lymph node; TNM = tumor node metastasis.) The Annals of Thoracic Surgery 2007 83, 1265-1272DOI: (10.1016/j.athoracsur.2006.12.003) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions