HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Chang Hyun Kang Young Tae Kim Sook-Whan Sung Joo Hyun Kim Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kang, C. H. Articles by Kim, J. H. Search for Related Content PubMed PubMed Citation Articles by Kang, C. H. Articles by Kim, J. H. Related Collections Esophagus - cancer

Eur J Cardiothorac Surg 2007;31:154-160. doi:10.1016/j.ejcts.2006.10.033
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Lymphadenectomy extent is closely related to long-term survival in esophageal cancer

^a Department of Thoracic and Cardiovascular Surgery, Cancer Research Institute, Seoul National University Hospital, Xenotransplantation Research Center, Clinical Research Institute, Seoul National University College of Medicine, Seoul, South Korea
^b Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Kyeonggi-do, South Korea

Received 1 September 2006; received in revised form 16 October 2006; accepted 23 October 2006.

^_* Corresponding author. Address: Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, 28 Yongon-dong, Jongro-gu, Seoul 110-744, South Korea. Tel.: +82 2 2072 3010; fax: +82 2 762 3566. (Email: chkang{at}snu.ac.kr).

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.

Key Words: Esophageal cancer • Lymphadenectomy • Survival