Abstract： Objective To evaluate the clinical significance of bilateral supraclavicular lymph node dissection after esophagectomy for patients with intrathoracic esophageal carcinoma. Methods A total of 197 patients with esophageal carcinoma but no obvious supraclavicular lymph node metastasis who underwent esophagectomy in Zhongshan Hospital of Xiamen University from March 1997 to September 2004 were included in this study. All the patients were divided into 2 groups， the control group and the study group. In the control group (non-supraclavicular lymphadenectomy group)， there were 96 patients including 62 males and 34 females with their age of 40-69 （55.2±3.1） years， who received 2-field lymphadenectomy (intrathoracic lymphatic drainage area and left paracardial lymph nodes) without supraclavicular lymph node dissection. In the study group (supraclavicular lymphadenectomy group)， there were 101 patients including 68 males and 33 females with their age of 41-68 （53.8±4.5） years， who received 3-field lymphadenectomy including intrathoracic lymphatic drainage area， left paracardial lymph nodes and bilateral supraclavicular lymph node dissection. Postoperative survival rate， lymph node metastasis rate， anastomotic site recurrence rate， and long-term supraclavicular lymph node metastasis rate were compared between the 2 groups. Results The overall 5-year survival rate of all the patients was 39.59% （78/197）. There was no statistical difference in 5-year survival rate between the 2 groups ［37.50％ （36/96） vs. 41.58％（42/101）， P＞0.05］. However， the 5-year survival rate of the patients with esophageal carcinoma in the upper third of the esophagus in the study group was significantly higher than that of the control group ［38.10％（8/21） vs. 29.17％ （7/24）， P＜0.05］. The intrathoracic lymph node metastasis rate （14.58% vs. 12.87%）， abdominal lymph node metastasis rate （6.25% vs. 7.92%）and anastomotic site recurrence rate （5.20% vs. 5.94%）of the control group and study group were not statistically different （P＞0.05）. However， long-term supraclavicular lymph node metastasis rate of the study group was significantly lower than that of the control group （2.97％ vs. 8.33％， P＜0.05） Conclusion Bilateral supraclavicular node dissection can significantly increase postoperative survival rate and decrease long-term supraclavicular lymph node metastasis rate of patients with esophageal carcinoma in the upper third of the esophagus.
Citation： CAI Yingjie,HE Zefeng,KE Sunkui,DUAN Hongbing,FU Chengguo,GAO Huichuan.. Clinical Significance of Bilateral Supraclavicular Lymph Node Dissection for Intrathoracic Esophageal Carcinoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2013, 20(1): 63-66. doi: Copy