Impact of splenic node dissection on short-term outcome and survival following esophagectomy

The purpose of this study was to investigate the impact of splenic node dissection on short-term outcomes and survival after esophagectomy in patients with thoracic esophageal squamous cell carcinoma (ESCC).

We retrospectively analyzed the clinical data of 1282 consecutive patients with thoracic ESCC who underwent esophagectomy in the First Affiliated Hospital of Zhengzhou University from January 2005 to December 2013.

Of all 1282 patients, there were 964 without splenic node dissection and 318 with splenic node dissection. The average operative time in the splenic node nondissection group was significantly shorter than dissection group, and blood loss in the nondissection group was significantly less than dissection group (all p < 0.05). The comparison of overall survival curves between the splenic node nondissection group and dissection group showed no significant difference (p > 0.05). In the dissection group, there were 15 patients (4.7%) with confirmed splenic node metastasis by postoperative pathologic examination. Patients with splenic node metastasis had a worse cumulative survival compared with those without splenic node metastasis (p < 0.05). Compared with nondissection group, prophylactic splenic node dissection failed to improve the survival rate significantly (p > 0.05).

The frequency of splenic node metastasis is low in thoracic ESCC. Splenic node metastasis indicates a worse prognosis for patients with thoracic ESCC. Splenic node dissection might be futile for patients with thoracic ESCC.