title: Clinical outcomes and prognosis after thoracoscopic esophagectomy with two-field lymph node dissection for lower thoracic esophageal cancer.
abstract: OBJECTIVE
  The aim of this study was to evaluate the clinical outcomes and prognostic factors of thoracoscopic esophagectomy with two-field lymph node dissection for lower thoracic esophageal cancer.
  
  
  METHODS
  From January 2003 to December 2011, 84 patients with lower thoracic esophageal cancer underwent thoracoscopic esophagectomy with two-field lymph node dissection. Clinicopathological information, postoperative complications, mortality, type of recurrent diseases and factors predictive of survival were analyzed.
  
  
  RESULTS
  Postoperative complications were diagnosed in 37 patients and the mortality was 1.2%. Lymph node metastases were found in 43 patients (51.2%). The 5-year survival rate of all patients was 60.5%. Pathological T factor, lymph node metastasis, pathological staging, and venous invasion were independent prognostic factors. Among the patients with lymph node metastasis, the survival rate of those with upper mediastinal and/or celiac area involvement was significantly worse than that of those without involvement of these areas.
  
  
  CONCLUSIONS
  Thoracoscopic esophagectomy with two-field lymph node dissection is a safe and appropriate surgical intervention for patients with lower thoracic esophageal cancer without complication of lymph node metastases to the upper mediastinum and/or celiac area.
authors: Department of Upper Gastrointestinal Surgery, Hyogo College of Medicine, 1-1, Mucogawa-machi, Nishinomiya City, Hyogo, 663-8501, Japan. mtake@hyo-med.ac.jp
authors: Masashi
authors: M
authors: Takemura
authors: Takaaki
authors: T
authors: Hori
authors: Yushi
authors: Y
authors: Fujiwara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D013906:Thoracoscopy; D016896:Treatment Outcome