Therapeutic efficacy comparison of two surgical procedures to treat middle thoracic esophageal carcinoma.
BACKGROUND
The aim of this study was to evaluate the therapeutic efficacy of two surgical procedures used to treat middle thoracic esophageal squamous cell carcinoma and compare the results.


METHODS
A total of 167 patients with middle thoracic esophageal squamous cell carcinoma were included in the study, including 102 patients who underwent Ivor-Lewis esophagectomy and another 65 who underwent dual-incision esophagectomy through the left chest and neck (Dual-incision). The Kaplan-Meier method was used to calculate the survival rate, and Cox regression analysis was performed to identify prognostic risk factors.


RESULTS
Perioperative complications occurred in 35 patients (21%). The incidence rate of recurrent laryngeal nerve injury and anastomotic leakage was higher in the Dual-incision group (p < 0.05), and the incidence rate of gastric retention was higher in the Ivor-Lewis group. However, there were no statistically significant differences. The 3-year local recurrence rate was 37.3% in the Ivor-Lewis group and 40% in the Dual-incision group (p > 0.05). The overall 5-year survival rate was 34.6%; the rates of the Ivor-Lewis group and the Dual-incision group were 36.0 and 32.3%, respectively (p > 0.05). The Cox analysis indicated that the pTNM staging was an independent prognostic risk factor (p = 0.00, hazard ratio = 2.69).


CONCLUSIONS
Both Ivor-Lewis esophagectomy and Dual-incision esophagectomy through the left chest and neck are options for treating middle thoracic esophageal squamous cell carcinoma. It is suggested that a patient's individual condition be taken into account when choosing the operative approach.
Yu
Yang
Y
Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, 250021, Shandong Province, China.
Wang
Zhou
Z
Liu
Xiang-Yan
XY
Zhu
Xiao-Feng
XF
Chen
Qing-Fu
QF
D000714:Anastomosis, Surgical; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D061226:Recurrent Laryngeal Nerve Injuries; D012307:Risk Factors; D016896:Treatment Outcome