title: Therapeutic efficacy comparison of two surgical procedures to treat middle thoracic esophageal carcinoma.
abstract: 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.
authors.affiliation: Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, 250021, Shandong Province, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yu
authors.forename: Zhou
authors.initials: Z
authors.lastname: Wang
authors.forename: Xiang-Yan
authors.initials: XY
authors.lastname: Liu
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Zhu
authors.forename: Qing-Fu
authors.initials: QF
authors.lastname: Chen
mesh_terms: 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