European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2025
Comparison of long-term outcomes of 2.5- and 3-field lymph node dissections for esophageal squamous cell carcinoma.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Chen Maohui, Zeng Taidui, Huang Yizhou, Zhang Shuliang, Chen Chun, Zheng Bin
Аннотация
OBJECTIVES: Previous studies demonstrated that the mesoesophageal suspension technique is safe and effective for thoracoscopic lymph node dissection in esophageal squamous cell carcinoma (ESCC), but direct comparison with 3-field dissection is lacking. This study aimed to compare 2.5- and 3-field lymph node dissections in terms of survival benefits, recurrence patterns, and complications in patients with ESCC.
METHODS: This was a retrospective study of patients with ESCC who underwent 2.5- or 3-field lymph node dissection (FLD). The outcomes included 30-day mortality, postoperative complications, overall survival (OS), disease-free survival (DFS), and recurrence pattern.
RESULTS: A total of 353 patients with ESCC were included in this study. After propensity score matching, the frequency of all complications (27.8 % vs. 18.3 %, P = 0.072), recurrent laryngeal nerve injury (5.6 % vs. 0.8 %, P = 0.033) and respiratory complications (19.8 % vs. 11.9 %, P = 0.084) was higher in the 3-field group compared with the 2.5-field group. Smaller number of dissected lymph nodes (median, 31.5 vs. 41, P < 0.001) but comparable number of metastatic lymph nodes (median, 0 vs. 1, P = 0.143) was found in the 2.5-field group compared with the 3-field group. The rate of positive supraclavicular lymph nodes was 1.6 % in the 3-field group. There were no differences OS and DFS between the two groups, with median OS and DFS not reached in both groups. Recurrence pattern of all stage patients was similar between the two groups.
CONCLUSION: The 2.5- and 3-FLD have comparable survival benefits for patients with ESCC, while the 2.5-FLD has a lower risk of complications.
METHODS: This was a retrospective study of patients with ESCC who underwent 2.5- or 3-field lymph node dissection (FLD). The outcomes included 30-day mortality, postoperative complications, overall survival (OS), disease-free survival (DFS), and recurrence pattern.
RESULTS: A total of 353 patients with ESCC were included in this study. After propensity score matching, the frequency of all complications (27.8 % vs. 18.3 %, P = 0.072), recurrent laryngeal nerve injury (5.6 % vs. 0.8 %, P = 0.033) and respiratory complications (19.8 % vs. 11.9 %, P = 0.084) was higher in the 3-field group compared with the 2.5-field group. Smaller number of dissected lymph nodes (median, 31.5 vs. 41, P < 0.001) but comparable number of metastatic lymph nodes (median, 0 vs. 1, P = 0.143) was found in the 2.5-field group compared with the 3-field group. The rate of positive supraclavicular lymph nodes was 1.6 % in the 3-field group. There were no differences OS and DFS between the two groups, with median OS and DFS not reached in both groups. Recurrence pattern of all stage patients was similar between the two groups.
CONCLUSION: The 2.5- and 3-FLD have comparable survival benefits for patients with ESCC, while the 2.5-FLD has a lower risk of complications.
Предметные рубрики MeSH
HumansLymph Node ExcisionMaleFemaleEsophageal NeoplasmsMiddle AgedRetrospective StudiesEsophageal Squamous Cell CarcinomaAgedDisease-Free SurvivalPostoperative ComplicationsCarcinoma, Squamous CellNeoplasm Recurrence, LocalSurvival RateLymphatic MetastasisPropensity ScoreTreatment OutcomeLymph NodesEsophagectomyNeoplasm Staging