[A comparison of clinical outcomes between standard and total two-field lymphadenectomy for squamous cell carcinoma of the lower thoracic esophagus].

ABSTRACT

OBJECTIVE: To explore the suitable lymphadenectomy for squamous cell carcinoma of the lower thoracic esophagus. METHODS: From January 2004 to December 2007, 300 patients with lower thoracic esophageal squamous cell carcinoma underwent Ivor-Lewis esophagectomy with 2-field lymphadenectomy in our department. All cases were retrospectively analyzed. 143 cases underwent standard lymphadenectomy(standard group), 157 cases underwent total lymphadenectomy(total group). The clinical and pathological characteristics, the status of lymph node metastases, postoperative complications and survival rates were compared between two groups. RESULTS: There were more lymph nodes dissected(30 ± 10 vs 26 ± 8, P = 0.001)and higher respiratory failure rate(16.6% vs 0.7%, P = 0.038) in total group than in standard group. The 5-year survival rate was 28.9% and 30.2%, respectively(P = 0.936). CONCLUSION: The total 2-field lymphadenectomy doesn't provides better survival benefit for patients with squamous cell carcinoma of the lower thoracic esophagus, instead more complications occurred. For local advanced tumor, 3-field lymphadenectomy and comprehensive treatment should be considered.