title: Three-field lymph node dissection in the treatment of thoracic esophageal carcinoma: the Turkish experience.
abstract: The role of extended lymphatic dissection on the prognosis and outcome of thoracic esophageal carcinoma is still controversial. The aim of this study was to determine the impact of three-field lymphatic dissection on the survival and recurrence rates of patients with thoracic carcinoma of the esophagus. Forty-six patients with primary squamous cell carcinoma of the thoracic esophagus underwent esophagectomy with three-field lymphatic dissection between 1992 and 2003. Recurrence and survival rates were examined as well as complications. Overall survival for the patients was 45.6 months and 5-year survival rate was 56%. Five-year survival rates for patients with Stage 2A, 2B, 3 and 4 were 68%, 0%, 53% and 33%, respectively. There was no Stage 1 patient. Mean disease-free survival was 41.4 months. Sixty three percent of patients had node-negative disease (5-year survival rate, 68.9%) and 37% had nodal metastases (5-year survival rate, 33.7%) (P = 0.002). Surgical morbidity was seen in 35 patients (76.1%). Conclusively, lymph node involvement in patients with thoracic esophageal carcinoma is the major determinant of prognosis and survival. Extended lymphatic dissection provides higher disease-free and overall survival rates and our study revealed the highest survival rate for thoracic esophageal carcinoma, to best of our knowledge.
authors.affiliation: Department of Surgery, School of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Z
authors.initials: Z
authors.lastname: Ferahköşe
authors.forename: A Ziya
authors.initials: AZ
authors.lastname: Anadol
authors.forename: H
authors.initials: H
authors.lastname: Gökbayir
authors.forename: A
authors.initials: A
authors.lastname: Dursun
authors.forename: E
authors.initials: E
authors.lastname: Oztürk
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000401:mortality; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D015996:Survival Rate; D013908:Thoracotomy; D014421:Turkey