[Ivor Lewis esophagectomy with two-field lymph node dissection for squamous cell carcinoma of the lower thoracic esophagus].

BACKGROUND & OBJECTIVE: Esophagectomy with local regional lymph node dissection is the main treatment for lower thoracic esophageal carcinoma. This study was to assess the clinical outcomes of Ivor Lewis esophagectomy with two-field lymph node dissection for squamous cell carcinoma of the lower thoracic esophagus.

METHODS: Clinical data of 73 patients with squamous cell carcinoma of the lower thoracic esophagus, who underwent Ivor Lewis esophagectomy with two-field lymph node dissection from Jan. 1998 to Dec. 2001, were analyzed retrospectively. Kaplan-Meier method was used for survival analysis.

RESULTS: The morbidity of postoperative complications was 15.1% with a 2.7% mortality rate. The lymph node metastasis rate was 71.2%; the metastasis rate of the upper mediastinal nodes was 17.8%. Of the 73 patients, 5 were at stage I, 35 at stage II, 32 at stage III, and 2 at stage IV. The overall 5-year survival rate was 23.3%. The 5-year survival rate was 38.1% for N0 patients and 17.3% for N1 patients (P<0.01), and was 31.2% for stage IIa patients, 27.8% for stage IIb patients, and 12.5% for stage III patients (P<0.01).

CONCLUSION: Ivor Lewis esophagectomy with two-field lymph node dissection for squamous cell carcinoma of the lower thoracic esophagus is a safe operation, and may increase the chances of complete resection.