ObjectiveTo explore the discipline of superior mediastinum lymph node metastasis of esophageal carcinoma, laying a foundation for the standardization of lymphadenectomy. MethodsWe retrospectively analyzed the clinical data of 586 patients with esophageal carcinoma in our hospital between June 2009 and June 2014. There were 489 males and 97 females at age of 61.61±7.92 years. We analyzed the discipline of lymph node metastasis in these patients. ResultsThe mean number of lymph nodes dissection was 20.48±11.01 per patient. A total of 1 212 lymph nodes metastasis was found in 326 patients (55.63%). The ratio of lymph nodes metastasis in the superior mediastinum, lower mediastinum, and abdominal cavity was 29.35%, 25.94%, and 31.74% respectively with no statistical difference among the three groups (χ2=4.839, P=0.089). In regard to upper thoracic esophageal carcinoma, the ratio of lymph nodes metastasis in the superior mediastinum, lower mediastinum, and abdominal cavity was 43.48%, 3.73%, and 13.73% respectively with higher metastasis rate (χ2=32.692, P=0.000) in the upper mediastinum. In middle thoracic esophageal carcinoma patients, there was no statistical differences in the ratio of lymph node metastasis among upper mediastinum (28.19%), lower mediastinum (29.53%), and abdominal cavity (31.54%, χ2=0.566, P=0.753). While in the patients with the lower thoracic esophageal carcinoma, the ratio of lymph nodes metastasis in the superior mediastinum, lower mediastinum, and abdominal cavity was 22.92%, 27.08%, and 41.67%, respectively with higher ratio of lymph nodes metastasis in abdominal cavity (χ2=17.542, P=0.000). The involved ratio of the right recurrent lymph nodes (19.80%) was the highest among all the lymph nodes in the superior mediastinum (χ2=112.304, P=0.000). ConclusionUpper mediastinum is one of the predilection sites of lymph nodes metastasis of esophageal carcinoma, focusing on the resection of superior mediastinum lymph nodes, especially the right recurrent lymph nodes can decrease the chances of relapse by reducing residual tumor cells.