Target Volume Determination 2015

The regional lymph node “map” is important for clinical staging and lymph node sampling All lymphatic channels intercommunicate- lymphatic fluid from any portion of the oesophagus may move to any other portion and may spread to any region of the thorax or draining nodes.

Tumours in the distal oesophagus are more likely to metastasize to the abdomen, Lymphatic spread of cancer in the upper or midesophagus can also result in metastasis to celiac or other abdominal lymph nodes.

The flow of lymph in the upper two-thirds of the oesophagus tends to be upward, whereas that in the distal third tends to be downward