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01-01-2014 | Original Article

Impact of Thoracic Recurrent Laryngeal Node Dissection: 508 Patients with Tri-Incisional Esophagectomy

Authors: Zihui Tan, Guowei Ma, Jinming Zhao, Amos Ela Bella, Tiehua Rong, Jianhua Fu, Yuqi Meng, Kongjia Luo, Dongrong Situ, Peng Lin

Published in: Journal of Gastrointestinal Surgery | Issue 1/2014

Abstract

Background

To evaluate the feasibility and safety of recurrent laryngeal nerve (RLN) lymph node (LN) dissection, this study compared the postoperative complications and survival between modern two-field lymphadenectomy (MTL) and modified standard two-field lymphadenectomy (MSTL) by using the propensity score matching method.

Methods

After generating propensity scores given the covariates of age, sex, tumor length, tumor location, tumor grade, and clinical stage, 254 patients with MTL were matched to 254 MSTL patients using the nearest available score matching. The LNs resected during MSTL were paraesophageal and preparatracheal LNs in the upper mediastinum, in addition to those resected during standard two-field lymphadenectomy.

Results

RLN LNs were those most commonly affected by nodal metastasis in our series (26 %). Metastasis in RLN LNs was found in around 35, 25, and 20 % of patients with cancer in the upper, middle, and lower thoracic esophagus, respectively. LN metastasis was confined to the RLN region in 49 patients. Even 35 % of patients with pT1 tumors had positive RLN LNs. MTL increased the mean number of resected LNs when compared to MSTL (29 vs.15; p < 0.001). Recurrence was more frequent in those assigned MSTL than those assigned MTL (p < 0.001). The 5-year overall survival (OS) and disease-free survival (DFS) rate for MTL were 50.7 and 42 % compared to 35.3 and 28.2 % for MSTL (both p < 0.001), respectively. Postoperative complications were more frequent following MTL when compared to the MSTL. However, no statistically significant difference in postoperative complications was observed between the two groups.

Conclusions

Adding the removal of RLN LNs might improve OS and DFS with acceptable morbidity for patients with ESCC.

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Title: Impact of Thoracic Recurrent Laryngeal Node Dissection: 508 Patients with Tri-Incisional Esophagectomy
Authors: Zihui Tan
Guowei Ma
Jinming Zhao
Amos Ela Bella
Tiehua Rong
Jianhua Fu
Yuqi Meng
Kongjia Luo
Dongrong Situ
Peng Lin
Publication date: 01-01-2014
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 1/2014
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-013-2411-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of Thoracic Recurrent Laryngeal Node Dissection: 508 Patients with Tri-Incisional Esophagectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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