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Journal of Gastrointestinal Surgery

, Volume 21, Issue 10, pp 1584–1590 | Cite as

Extent of Mediastinal Lymphadenectomy and Survival in Superficial Esophageal Squamous Cell Carcinoma

  • Seong Yong Park
  • Dae Joon KimEmail author
  • Taeil Son
  • Yong Chan Lee
  • Chang Young Lee
  • Jin Gu Lee
  • Kyung Young Chung
Original Article
  • 232 Downloads

Abstract

Background

The aim of this study is to investigate the utility of total mediastinal lymphadenectomy (ML) in superficial esophageal squamous cell carcinoma (ESCC).

Methods

The medical records of 129 patients who underwent esophagectomy and lymph node dissection for pathologically confirmed pT1 ESCC between July 2006 and December 2014 were retrospectively reviewed. Limited ML, such as traditional 2-field or transhiatal esophagectomy, was performed in 42 patients (group 1), and total ML, including the bilateral recurrent laryngeal nerve nodes, was performed in 87 patients (group 2).

Results

R0 resection was achieved in all patients, and the number of dissected nodes was 28.0 ± 11.4 and 44.8 ± 16.1 in groups 1 and 2 (p < 0.001), respectively. The complication profile was similar in the two groups, but there were two operative mortalities in group 2. During a median follow-up of 32.4 months, loco-regional failure was found in 14.3% of group 1 and 3.5% of group 2 (p = 0.001). There was a significant difference in the 3-year overall survival (95.1% in group 2 vs. 83.3% in group 1, p = 0.043), and the 3-year disease-free survival rates (92.3% in group 2 vs. 73.7% in group 1, p = 0.001). On multivariate analysis, the extent of ML (HR, 5.200; 95% CI, 1.532 ~ 17.645; p = 0.008) and pT1b lesion classification (HR, 4.747; 95% CI, 1.024 ~ 21.997; p = 0.047) was a factor predictive of disease-free survival.

Conclusions

Total ML might be beneficial, especially in cases of pT1b ESCC, because it could lead to a lower incidence of recurrence and longer survival times.

Keywords

Esophagus Oncology Outcomes 

Notes

Acknowledgements

Author Contributions

Conception and design: Dae Joon Kim

Administrative support: Seong Yong Park, Dae Joon Kim

Provision of study materials or patients: All authors

Collection and assembly of data: Seong Yong Park

Data analysis and interpretation: All authors

Manuscript writing: Seong Yong Park, Dae Joon Kim

Final approval of manuscript: All authors

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Copyright information

© The Society for Surgery of the Alimentary Tract 2017

Authors and Affiliations

  • Seong Yong Park
    • 1
  • Dae Joon Kim
    • 1
    Email author
  • Taeil Son
    • 2
  • Yong Chan Lee
    • 3
  • Chang Young Lee
    • 1
  • Jin Gu Lee
    • 1
  • Kyung Young Chung
    • 1
  1. 1.Department of Thoracic and Cardiovascular SurgeryYonsei University College of MedicineSeoulRepublic of Korea
  2. 2.Department of SurgeryYonsei University College of MedicineSeoulRepublic of Korea
  3. 3.Division of Gastroenterology, Department of Internal MedicineYonsei University College of MedicineSeoulRepublic of Korea

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