[The significance of the extensive systematic lymphadenectomy for thoracic esophageal carcinoma]

1.

One hundred and seventy nine patients with thoracic esophageal carcinoma who underwent an intrathoracic esophagectomy combined with systematic lymphadenectomy were investigated. They were roughly classified into two groups, i.e., those who received extensive lymphadenectomy in bilateral cervical and upper mediastinal regions (A group: 78 subjects), and those who underwent ordinary limited dissection of the lymph nodes in the left cervical and upper mediastinum (B group: 101 subjects). 2.

Cumulative 5-year survival rate of advanced cancer patients was 31.3% in A and 22.5% in B, the difference being of significance (p less than 0.05). The rate of postoperative mortality showed no difference between both groups, i.e., 3.8% in A and 4.9% in B groups. However, the incidence of postoperative pulmonary complication was 17.9% in A and 13.9% in B. Recurrent nerve palsy developed in frequencies of 39.7% and 17.8% in A and B groups respectively. 3.

The degree of extended lymph node metastasis in carcinoma of the thoracic esophagus was closely correlated with its prognosis, and hence it is extremely important to perform intrathoracic esophagectomy with extensive systematic lymphadenectomy aiming at the favorable result in surgical treatment. It is also required to take preventive measures against postoperative complications.