title: Extent of lymph node dissection: common hepatic artery lymph node dissection can be omitted for esophageal squamous cell carcinoma.
abstract: OBJECTIVE
  Controversy persists regarding the adequate extent of lymph node (LN) dissection in thoracic esophageal cancer (EC) surgery. Oncologic efficacy should be balanced with the increased risk of postoperative complications after aggressive radical LN dissection. Here, we evaluate the effectiveness of common hepatic artery LN dissection in surgery for thoracic esophageal squamous cell carcinoma.
  
  
  METHODS
  Among a total of 1,563 EC patients who underwent surgery from May 2005 to December 2012 at the Fudan University Shanghai Cancer Center, 1,248 thoracic esophageal squamous cell carcinoma were selected for this study, including 682 patients who underwent esophagectomy with common hepatic artery LN dissection and 566 patients who underwent esophagectomy without common hepatic artery LN dissection. The clinical data of patients were retrospectively analyzed. In addition, the locoregional LN metastasis, relationship between metastatic rates of common hepatic artery LN and clinicopathological factors were analyzed. A propensity score match analysis were performed to control for potential differences in the characteristics of patients with EC cell carcinoma, and postoperative complications were analyzed after propensity score-matching.
  
  
  RESULTS
  The metastatic rate of common hepatic LN was 3.5%. Logistic regression analysis revealed tumor diameter, N classification and pTNM stage were risk factors for common hepatic LN metastasis. Matching based on propensity scores produced 361 patients in each group. The overall incidence of postoperative complications was 32.70% and 35.45%, respectively, no significant difference was found (P=0.432).
  
  
  CONCLUSIONS
  The metastatic rate of common hepatic artery LN is low. For patients who undergo resection for Stage I thoracic esophageal squamous cell carcinoma, the dissection of common hepatic artery LN may be safely omitted.
authors.affiliation: 1 Department of Thoracic Surgery, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Department of Thoracic Surgery, Nan Jing Chest Hosptial, Nanjing 210029, China ; 4 Department of Pathology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Ma
authors.affiliation: 1 Department of Thoracic Surgery, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Department of Thoracic Surgery, Nan Jing Chest Hosptial, Nanjing 210029, China ; 4 Department of Pathology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.affiliation: 1 Department of Thoracic Surgery, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Department of Thoracic Surgery, Nan Jing Chest Hosptial, Nanjing 210029, China ; 4 Department of Pathology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China.
authors.forename: Su
authors.initials: S
authors.lastname: Yang
authors.affiliation: 1 Department of Thoracic Surgery, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Department of Thoracic Surgery, Nan Jing Chest Hosptial, Nanjing 210029, China ; 4 Department of Pathology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
authors.affiliation: 1 Department of Thoracic Surgery, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Department of Thoracic Surgery, Nan Jing Chest Hosptial, Nanjing 210029, China ; 4 Department of Pathology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Zhu
authors.affiliation: 1 Department of Thoracic Surgery, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Department of Thoracic Surgery, Nan Jing Chest Hosptial, Nanjing 210029, China ; 4 Department of Pathology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China.
authors.forename: Hecheng
authors.initials: H
authors.lastname: Li
authors.affiliation: 1 Department of Thoracic Surgery, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Department of Thoracic Surgery, Nan Jing Chest Hosptial, Nanjing 210029, China ; 4 Department of Pathology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China.
authors.forename: Jiaqing
authors.initials: J
authors.lastname: Xiang
authors.affiliation: 1 Department of Thoracic Surgery, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Department of Thoracic Surgery, Nan Jing Chest Hosptial, Nanjing 210029, China ; 4 Department of Pathology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China.
authors.forename: Yawei
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: 1 Department of Thoracic Surgery, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Department of Thoracic Surgery, Nan Jing Chest Hosptial, Nanjing 210029, China ; 4 Department of Pathology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032, China.
authors.forename: Haiquan
authors.initials: H
authors.lastname: Chen
keywords: Esophageal squamous cell carcinoma; common hepatic artery lymph node (common hepatic artery LN); lymph node dissection (LN dissection); propensity score match