title: Clinical course and outcome after esophagectomy with three-field lymphadenectomy in esophageal cancer.
abstract: BACKGROUND
  Esophagectomy with three-field lymphadenectomy has been performed for esophageal cancer. Detailed analysis of cause of death and mode of recurrence is required to determine the need for further adjuvant therapy and follow-up.
  
  
  METHODS
  A total of 208 patients who underwent esophagectomy through right thoracotomy with three-field lymphadenectomy were enrolled into the present study. Mode of first recurrence was divided into four groups: lymph node, hematogenous, mixed, and local recurrence.
  
  
  RESULTS
  Excluding 16 hospital deaths, the number of deaths and 5-year survival rates were 104 patients and 7.8% for cancer recurrence, 12 patients and 53.8% for second primary cancers in other organs, and 34 patients and 31.0% for causes of death unrelated to carcinoma. In the 104 patients with relapse, 5-year survival rate of patients was 14.3% with lymph node recurrence (n = 29), 9.1% with hematogenous recurrence (n = 32), 3.1% with mixed recurrence (n = 35), and 12.5% with local recurrence (n = 8).
  
  
  CONCLUSIONS
  To improve outcomes for esophagectomy with three-field lymphadenectomy, early detection of recurrent disease and regular examination of the entire body for secondary cancer is necessary.
authors.affiliation: Surgical Oncology and Digestive Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan. natsugoe@m2.kufm.kagoshima-u.ac.jp
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
authors.forename: Masataka
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okumura
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Uchikado
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Setoyama
authors.forename: Ken
authors.initials: K
authors.lastname: Sasaki
authors.forename: Toshihide
authors.initials: T
authors.lastname: Sakurai
authors.forename: Itaru
authors.initials: I
authors.lastname: Omoto
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Owaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shinchi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ueno
authors.forename: Sumiya
authors.initials: S
authors.lastname: Ishigami
mesh_terms: D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D012189:Retrospective Studies; D016896:Treatment Outcome