title: The significance of subcarinal dissection in esophageal cancer surgery.
abstract: OBJECTIVE
  The purpose of this study was to investigate the impact of subcarinal dissection on short-term outcome and survival following esophagectomy in patients with thoracic esophageal squamous cell carcinoma.
  
  
  METHODS
  A total of 2252 patients underwent an esophagectomy for esophageal cancer from January 1997 to December 2008, of whom 1419 patients met the selection criteria. There were 335 cases without a subcarinal dissection and 1084 with a subcarinal dissection. Short-term outcomes and survival following the esophagectomy between the subcarinal non-dissection group and dissection group were compared.
  
  
  RESULTS
  The average operation time of the subcarinal dissection group was longer than that of the non-dissection group (227 vs 208 min, P < 0.05). Both blood loss (246 vs 231 ml) and postoperative pleural drainage volume (1033 vs 950 ml) of the dissection group were significantly greater than in the non-dissection group (P < 0.05). For the entire cohort, the overall survival rate of the subcarinal non-dissection group was significantly lower than the dissection group (54 vs 36 mo., P < 0.05). However, in the N1-3 subgroup, no significant difference was found in overall survival rate between the two groups (P > 0.05). In the N0 subgroup the overall survival rate of the subcarinal non-dissection group was significantly lower than that of the dissection group (P < 0.05).
  
  
  CONCLUSIONS
  Subcarinal dissection is still necessary in esophagectomy for esophageal squamous cell carcinoma.
authors.affiliation: Department of Thoracic Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Hu
authors.forename: Yayong
authors.initials: Y
authors.lastname: Liang
authors.forename: Shuishen
authors.initials: S
authors.lastname: Zhang
authors.forename: Yi
authors.initials: Y
authors.lastname: Hu
authors.forename: Jingeng
authors.initials: J
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000601:surgery*; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: esophageal squamous cell carcinoma; esophagectomy; lymph node metastasis; subcarinal dissection