Segment-specific patterns of regional lymph-node metastasis in primary small-cell carcinoma of the esophagus: A systematic review and meta-analysis

Table 2 Segment-specific station-level interpretation for multidisciplinary planning

Tumor segment	Dominant signal	Supporting evidence	Practical interpretation
Upper thoracic SCCE	Upper mediastinal and recurrent laryngeal nerve involvement; CHiSCEC high-risk stations No. 105, No. 106recR, and No. 106recL	Liu et al[9]; CHiSCEC[13]; Jiao et al[10]	upper mediastinal nodal assessment should be explicit; lower mediastinal assessment remains warranted when imaging, tumor length, or pathology suggests risk
Middle thoracic SCCE	Most diffuse pattern, including upper and middle mediastinal, recurrent nerve, perigastric, and abdominal compartments; CHiSCEC high-risk stations No.107, No. 108, and abdominal No. 7	Liu et al[9]; CHiSCEC[13]; Wu et al[11]	Bidirectional nodal evaluation is more defensible than a narrow peritumoral field
Lower thoracic SCCE	Dominant lower mediastinal, perigastric, and abdominal signal; CHiSCEC high-risk stations No. 107, No. 110, abdominal No. 2, and abdominal No. 7	Liu et al[9]; CHiSCEC[13]	Upper abdominal and perigastric risk should be weighed against operative and radiotherapy morbidity; upper mediastinal skip risk remains possible
Cross-segment issue	Skip metastasis and named station risk are clinically relevant but not yet independently linked to survival	Liu et al[9]; Xu et al[8]; CHiSCEC[13]	Standardized station reporting is needed before classical efficacy-index or station-specific survival claims can be made

SCCE: Small cell carcinoma of the esophagus.