Clinical course and outcome after esophagectomy with three-field lymphadenectomy in esophageal cancer

• Published in: Langenbeck's archives of surgery Vol. 395; no. 4; pp. 341 - 346
• Main Authors: Natsugoe, Shoji, Matsumoto, Masataka, Okumura, Hiroshi, Uchikado, Yasuto, Setoyama, Tetsuro, Sasaki, Ken, Sakurai, Toshihide, Omoto, Itaru, Owaki, Tetsuhiro, Shinchi, Hiroyuki, Ueno, Shinichi, Ishigami, Sumiya
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.04.2010
• Subjects: Abdominal Surgery; Cardiac Surgery; Esophageal Neoplasms - mortality; Esophageal Neoplasms - pathology; Esophageal Neoplasms - surgery; Esophagectomy; Female; General Surgery; Humans; Lymph Node Excision; Male; Medicine; Medicine & Public Health; Neoplasm Recurrence, Local - diagnosis; Original Article; Retrospective Studies; Thoracic Surgery; Traumatic Surgery; Treatment Outcome; Vascular Surgery; Recurrence; Three-field lymphadenectomy; Survival; Esophageal cancer
• ISSN: 1435-2443; 1435-2451
• DOI: 10.1007/s00423-010-0592-7

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. Materials and 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). Conclusion 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.