Three-field versus Two-field lymphoadenectomy for Upper or Middle Thoracic Esophageal Cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

蔡彦力 ,  郑勇 , 黄进启 , 向水 , 姚元波

恩施土家族苗族自治州中心医院心胸外科(湖北恩施 445000);

Corresponding author：

郑勇, Email: caiyl_2004@sina.com

Keywords：

食管癌; 外科治疗; 三野淋巴结清扫术; 完全二野淋巴结清扫术

DOI：

10.7507/1007-4848.20160118

Video：

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目的探讨胸中上段食管癌淋巴结清扫的合理范围。方法回顾性分析2010年1月至2013年10月我院134例胸中上段食管癌淋巴结清扫患者的临床资料。将患者分为两组：三野组，56例，男50例、女6例，年龄（55.4±9.6）岁，行三野淋巴结清扫根治术；二野组，78例，男69例、女9例，年龄（56.3±7.3）岁，行完全二野淋巴结清扫根治术。比较两组临床效果。结果三野组患者淋巴结转移率明显高于二野组（60.7%vs.42.3%，P < 0.05），主要差别在于三野组有较高的颈部淋巴结转移率（21.4%）。三野组与二野组患者上纵隔淋巴结转移率分别为33.9%和30.8%，差异无统计学意义（P>0.05）。三野组及二野组患者术后并发症发生率差异无统计学意义（P>0.05）。三野组及二野组患者术后１年生存率分别为96.3%和85.5%，差异有统计学意义（P < 0.05）；三野组及二野组患者术后1年内颈部淋巴结复发率分别为1.9%和11.8%，差异有统计学意义（P < 0.05）。结论三野淋巴结清扫根治术有助于提高胸中上段食管癌手术根治性，能减少术后局部复发和转移，提高患者术后生存率，相对于完全二野淋巴结清扫术并不显著增加手术并发症。

Citation： 蔡彦力, 郑勇, 黄进启, 向水, 姚元波. Three-field versus Two-field lymphoadenectomy for Upper or Middle Thoracic Esophageal Cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(5): 506-508. doi: 10.7507/1007-4848.20160118 Copy

1.	Sugiyama M, Morita M, Yoshida R, et al. Patterns and time of recurrence after complete resection of esophageal cancer. Surg Today, 2012, 42(1):752-758.
2.	毛友生, 赫捷, 程贵余, 等. 食管癌分期与治疗的共识、争议和建议. 中国癌症杂志, 2011, 21(7):511-517.
3.	蔡英杰, 何泽锋, 柯孙葵, 等. 胸段食管癌锁骨上淋巴结清扫的临床价值. 中国胸心血管外科临床杂志, 2013, 20(1):63-66.
4.	Liu Q, Cai XW, Wu B, et al. Patterns of failure after radical surgery among patients with thoracic esophageal squamous cell carcinoma:implications for the clinical target volume design of postoperative radiotherapy. Plos One, 2014, 9(5):e97225.
5.	Ding X, Zhang J, Li B, et al. A meta-analysis of lymph node metas-tasis in thoracic esophageal cancer. Br J Radiol, 2012, 85(1019):e1110-e1119.
6.	缪珑异, 相加庆. 食管癌三野淋巴结清扫根治术的价值. 中国癌症杂志, 2004, 14(2):194-196.
7.	Matsubara T, Ueda M, Abe T, et al. Unique distribution patterns of metastatic lymph nodes in patients with superficial carcinoma of the thoracic esophagus. Br J Surg, 1999, 86:669-673.
8.	Berger AC, Bloomenthal A, Weksler B, et al. Oncologic efficacy is not compromised, and may be improved with minimally invasive esophagectomy. J Am Coil Surg, 2011, 212:560-568.
9.	Udagawa H, Ueno M, Shinohara H, et al. The importance of grouping of lymph node stations and rationale of three-field lymphoadenectomy for thoracic esophageal cancer. J Surg Oncol, 2012, 106(6):742-747.
10.	Ye T, Sun Y, Zhang Y, et al. Three-field or two-field resection for thoracic esophageal cancer:a meta-analysis. Ann Thorac Surg, 2013, 96(6):1933-1941.
11.	Kato H, Fukuchi M, Miyazaki T, et al. Classification of recurrent esophageal cancer after radical esophagectomy with two or three field lymphadenectomy. J Anticancer, 2005, 25(5):3461-3467.

1. Sugiyama M, Morita M, Yoshida R, et al. Patterns and time of recurrence after complete resection of esophageal cancer. Surg Today, 2012, 42(1):752-758.
2. 毛友生, 赫捷, 程贵余, 等. 食管癌分期与治疗的共识、争议和建议. 中国癌症杂志, 2011, 21(7):511-517.
3. 蔡英杰, 何泽锋, 柯孙葵, 等. 胸段食管癌锁骨上淋巴结清扫的临床价值. 中国胸心血管外科临床杂志, 2013, 20(1):63-66.
4. Liu Q, Cai XW, Wu B, et al. Patterns of failure after radical surgery among patients with thoracic esophageal squamous cell carcinoma:implications for the clinical target volume design of postoperative radiotherapy. Plos One, 2014, 9(5):e97225.
5. Ding X, Zhang J, Li B, et al. A meta-analysis of lymph node metas-tasis in thoracic esophageal cancer. Br J Radiol, 2012, 85(1019):e1110-e1119.
6. 缪珑异, 相加庆. 食管癌三野淋巴结清扫根治术的价值. 中国癌症杂志, 2004, 14(2):194-196.
7. Matsubara T, Ueda M, Abe T, et al. Unique distribution patterns of metastatic lymph nodes in patients with superficial carcinoma of the thoracic esophagus. Br J Surg, 1999, 86:669-673.
8. Berger AC, Bloomenthal A, Weksler B, et al. Oncologic efficacy is not compromised, and may be improved with minimally invasive esophagectomy. J Am Coil Surg, 2011, 212:560-568.
9. Udagawa H, Ueno M, Shinohara H, et al. The importance of grouping of lymph node stations and rationale of three-field lymphoadenectomy for thoracic esophageal cancer. J Surg Oncol, 2012, 106(6):742-747.
10. Ye T, Sun Y, Zhang Y, et al. Three-field or two-field resection for thoracic esophageal cancer:a meta-analysis. Ann Thorac Surg, 2013, 96(6):1933-1941.
11. Kato H, Fukuchi M, Miyazaki T, et al. Classification of recurrent esophageal cancer after radical esophagectomy with two or three field lymphadenectomy. J Anticancer, 2005, 25(5):3461-3467.

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Three-field versus Two-field lymphoadenectomy for Upper or Middle Thoracic Esophageal Cancer

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