Document Detail


Lymphadenectomy extent is closely related to long-term survival in esophageal cancer.
MedLine Citation:
PMID:  17145185     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The optimal extent of lymphadenectomy during esophagectomy for esophageal cancer remains debatable. The aim of this study was to identify the effect of the extent of lymphadenectomy on survival and recurrence after esophagectomy in esophageal cancer. MATERIALS AND METHODS: Two hundred thirty-three patients who were operated on between January 1995 and December 2003 due to esophageal cancer were included. The study subjects were stage I, II, and III esophageal squamous cell carcinoma patients who had undergone curative resection without neoadjuvant chemotherapy or chemoradiation therapy. To analyze the extent of lymphadenectomy, lymph node stations were classified into three regions, namely, paraesophageal, upper thoracic, and abdominal regions, and patients were allocated to one of three groups, i.e., group 1 received lymphadenectomy in one region only, group 2 in two regions, and group 3 in three regions. RESULTS: The pathologic stages were stage I in 57 (24.5%), IIA in 69 (29.6%), IIB in 27 (11.6%), and III in 80 (34.3%). There were 67 patients in group 1, 102 in group 2, and 64 in group 3. The operative mortality rate was 2.1%. Postoperative morbidity rates and hospital stay periods were no different for the three groups. The overall 5-year survivals in groups 1, 2, and 3 were 21.2, 36.3, and 53.7%, respectively, and there were statistically significant differences between groups (p=0.019). Overall 5-year survival for those with N0 disease was different significantly in the groups (26.7, 56.8, and 74.4% in groups 1, 2, and 3, respectively; p=0.001). However, overall 5-year survival differences for N1 disease were not significant. Group 1 showed more frequent locoregional recurrence than groups 2 and 3 (34.3 vs 12.7% and 15.6%, p=0.002). However, distant recurrence was no different in the three groups. CONCLUSIONS: A wider extent of lymphadenectomy in esophageal cancer was associated with better long-term survival than limited lymphadenectomy, especially in N0 patients. In addition, increased survival was found to be inversely associated with locoregional recurrence.
Authors:
Chang Hyun Kang; Young Tae Kim; Sang-Hoon Jeon; Sook-Whan Sung; Joo Hyun Kim
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Publication Detail:
Type:  Journal Article     Date:  2006-12-04
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  31     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-30     Completed Date:  2007-04-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  154-60     Citation Subset:  IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Cancer Research Institute, Seoul National University Hospital, Clinical Research Institute, Seoul National University College of Medicine, Seoul, South Korea. chkang@snu.ac.kr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell / pathology,  secondary*,  surgery*
Epidemiologic Methods
Esophageal Neoplasms / pathology,  surgery*
Esophagectomy
Female
Humans
Lymph Node Excision / methods*
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Staging
Recurrence

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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