Cervico-thoraco-abdominal (3-field) lymph node dissection for carcinoma in the thoracic esophagus.
The efficacy of an extended radical lymph node dissection for carcinoma in the thoracic esophagus is controversial. Results of a multivariate analysis using clinical data from 127 cases collected from 1982 to 1988 are reported. Twenty-seven of these patients underwent an extended radical (cervico-thoraco-abdominal: 3 fields) lymph node dissection which was recently developed in Japan, while others underwent a standard (thoraco-abdominal: 2 fields) lymph node dissection. They all had a locally-curative resection of the tumor through a right thoracotomy. In this study, 13 factors commonly affecting prognosis were examined: sex, age, cancer location, tumor length, radiographic type, depth of invasion, lymph node metastasis, tumor differentiation, postoperative radiotherapy, chemotherapy, operative risk, postoperative complications, and 3-field or 2-field dissection. Based on the survival-rate curves using Kaplan-Meier's statistics, the 3-field dissection was superior to the 2-field dissection. Moreover, when other prognostic factors were adjusted using Cox's proportional hazards general linear model, the same result was obtained from survival-rate curves. From this analysis, it can be concluded that a 3-field dissection is a better approach for management of carcinoma in the thoracic esophagus.
Fujita
H
H
Department of Surgery, Kurume University School of Medicine, Japan.
Kakegawa
T
T
Yamana
H
H
Shima
I
I
Rikitake
H
H
Hyodo
M
M
Yokoyama
T
T
Fujii
T
T
Toh
U
U
Tsugane
S
S
D000005:Abdomen; D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D009333:Neck; D012189:Retrospective Studies; D013909:Thorax