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FASCICOLI E ARTICOLI   I PIÙ LETTI   eTOC

ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Periodicità: Bimestrale

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 1999 Ottobre;40(5):737-40

THORACIC PAPERS 

 ORIGINAL ARTICLES

Significance of ­three-­field lym­phad­e­nec­to­my for car­ci­no­ma of the tho­rac­ic esoph­a­gus ­based on ­depth of ­tumor infil­tra­tion, ­lymph ­nodal involve­ment and sur­vi­val ­rate

Tabira Y., Kitamura N., Yoshioka M., Tanaka M., Nakano K., Toyota N., Mori T.

From the First Department of Surgery, Kumamoto University School of Medicine Kumamoto City, Kumamoto, Japan

Background. Significance of ­three-­field lymh­pad­e­nec­to­my for car­ci­no­ma of the tho­rac­ic esoph­a­gus was exam­ined ret­ro­spec­tive­ly ­based on ­depth of ­tumor infil­tra­tion, ­lymph ­nodal involve­ments and ­long-­term sur­vi­val.
Methods. One hun­dred and fif­ty-two con­sec­u­tive ­patients who under­went cura­tive esoph­a­gec­to­my for tho­rac­ic car­ci­no­ma invad­ing to sub­mu­co­sa (pT1) or deep­er ­layers of the esoph­a­geal ­wall ­from 1983 to 1996 ­were exam­ined. Sixty-six ­patients under­went ­three-­field lym­phad­e­nec­to­my (3F) and 86 under­went two-­field lym­phad­e­nec­to­my (2F). Survival ­curves ­were com­pared ­between 3F and 2F ­after strat­ifi­ca­tions accord­ing to ­depth of ­tumor infil­tra­tion, the num­ber of pos­i­tive ­nodes (0, 1 to 4, 5 or ­more), and pos­i­tive intra­tho­rac­ic recur­rent ­nerve-­chain ­nodes.
Results. Overall 5-­year sur­vi­val ­rate for 3F was 43.8%, ­while it was 30.2% for 2F (p=0.07). In 41 ­patients ­with pT1 can­cers, the 5-­year sur­vi­val ­rate for 3F was 55.7%, ­while it was 41.4% for 2F (p=NS). In ­patients ­with can­cers invad­ing to mus­cu­lar­is pro­pria (pT2), the 5-­year sur­vi­val ­rate for 3F was 49.4%, ­while it was 30.7% for 2F (p=0.06). In ­patients ­with ­tumors invad­ing to adven­ti­tia, ­there was no sig­nif­i­cant dif­fer­ence. In ­patients ­with one to ­four pos­i­tive ­nodes, the 5-­year sur­vi­val ­rates for 3F was 50.1%, ­while it was 24.1% for 2F (p=0.01). There was no sig­nif­i­cant dif­fer­ence in the sub­groups ­with no pos­i­tive ­nodes and ­five or ­more. In sub­groups ­with pos­i­tive recur­rent ­nerve-­chain ­nodes, the 5-­year sur­vi­val ­rate for 3F was 27.9%, ­while it was 0% for 2F (p=0.01).
Conclusions. Significance of ­three-­field lym­phad­e­nec­to­my was ­found in ­patients ­with one to ­four pos­i­tive ­nodes or pos­i­tive intra­tho­rac­ic recur­rent ­nerve-­chain ­nodes.

lingua: Inglese


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