Ivor Lewis subtotal esophagectomy with two-field lymphadenectomy for squamous cell carcinoma of the lower thoracic esophagus.
OBJECTIVE
To evaluate the clinical outcome of Ivor Lewis subtotal esophagectomy with two-field lymphadenectomy for patients with squamous cell carcinoma of the lower thoracic esophagus.


METHODS
From January 1998 to December 2001, 73 patients with lower thoracic esophageal carcinoma underwent Ivor-Lewis subtotal esophagectomy with two-field lymphadenectomy. Clinicopathological information, postoperative complications, mortality and long term survival of all these patients were analyzed retrospectively.


RESULTS
The operative morbidity and mortality was 15.1% and the mortality was 2.7%. Lymph node metastases were found in 52 patients (71.2%). Nodal metastases to the upper, middle, lower mediastini and upper abdomen were found in 13 (17.8%), 15 (20.5%), 30 (41.1%), and 25 (34.2%) patients, respectively. Postoperative staging was as follows: stage I in 5 patients, stage II in 34 patients, stage III in 32 patients, and stage IV in 2 patients, respectively. The overall 5-year survival rate was 23.3%. For N0 and N1 patients, the 5-year survival rate was 38.1% and 17.3%, respectively (c2 = 22.65, P < 0.01). The 5-year survival rate for patients in stages IIa, IIb and III was 31.2%, 27.8% and 12.5%, respectively (c2 = 29.18, P < 0.01).


CONCLUSIONS
Ivor Lewis subtotal esophagectomy with two-field (total mediastinum) lymphadenectomy is a safe and appropriate operation for squamous cell carcinoma of the lower thoracic esophagus.
Wu
Jie
J
Department of Thoracico-abdominal Surgery, Zhejiang Cancer Hospital, 38 Guangji Road, Bangshan, Hangzhou, Zhejiang Province, China. wujiephd729@126.com
Chai
Ying
Y
Zhou
Xing-Ming
XM
Chen
Qi-Xun
QX
Yan
Fu-Lai
FL