title: [Value of 2-field lymphadenectomy in intrathoracic esophageal carcinoma].
abstract: Surgical procedures including the extent of systematic lymphadenectomy are still under discussion in the treatment of esophageal cancer. In the own patients' population 92 subtotal en bloc-esophagectomies with a standard two field lymphadenectomy were performed. A total of 1483 lymph nodes were resected in the thoracic and abdominal compartments with an incidence of 16.1% being metastatic. Stage pN1 disease occurred in 57.6% of the patients. The median number of lymph nodes resected in each specimen was 16, independent of tumor stage, -site or R-classification. The number of infiltrated nodes increased with tumor stages. R-classification, tumor stage and number of involved lymph nodes could be analyzed as prognostic factors. After R0-resection a median survival rate of 25.4 months could be achieved, following pN0-stage that of 27.4 months. In case of two metastatic lymph nodes the prognosis decreased significantly to 14.4 months (p < 0.01). Therefore, two field lymphadenectomy may show a therapeutic benefit only in a subgroup of patients with a limited number of lymph nodes infiltrated.
authors.affiliation: Klinik für Abdominal- und Transplantationschirurgie, Zentrum Chirurgie der Medizinischen Hochschule Hannover.
authors.forename: H J
authors.initials: HJ
authors.lastname: Meyer
authors.forename: J
authors.initials: J
authors.lastname: Jähne
authors.forename: W F
authors.initials: WF
authors.lastname: Hiller
authors.forename: G
authors.initials: G
authors.lastname: Tusch
authors.forename: C
authors.initials: C
authors.lastname: Stukenborg
authors.forename: R
authors.initials: R
authors.lastname: Pichlmayr
mesh_terms: D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate