Total oesophagectomy for squamous cell carcinoma with or without standard two field node dissection - a prospective...

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Esophageal and gastroesophageal junction (GEJ) cancer often presents at advanced stages with transmural invasion and lymphatic spread.
• R0 resection is the goal for curative intent surgery.
• The necessity and extent of lymphadenectomy in esophageal cancer remain debated.

Purpose of the Study:

• To compare the efficacy of standard two-field lymph node dissection versus non-formal lymph node dissection in esophageal carcinoma.
• To evaluate the impact of lymphadenectomy extent on staging, recurrence, and survival.

Main Methods:

• Retrospective analysis of 60 cases of esophageal carcinoma over two years.
• Comparison of outcomes between patients undergoing total esophagectomy with two-field lymphadenectomy and those with non-formal lymphadenectomy.

Main Results:

• Total esophagectomy with two-field lymphadenectomy provides a higher lymph node yield, ensuring accurate disease staging.
• Two-field lymphadenectomy is associated with significantly lower locoregional recurrence rates compared to non-formal dissection.
• Morbidity and mortality rates for two-field lymphadenectomy are acceptable and comparable to non-formal procedures.
• Distant recurrence rates were similar between the two groups.

Conclusions:

• Total esophagectomy with two-field lymphadenectomy is recommended as the standard surgical approach for resectable squamous cell carcinoma of the esophagus.
• This aggressive surgical strategy improves locoregional control and disease-free survival.
• The procedure is safe and effective, enhancing the accuracy of staging and treatment planning.