Caveolin-1 in multi drug resistance and two-field lymphadenectomy for thoracic esophageal squamous cell carcinoma

Caveolin-1 plays a very important role in the process of tumor cell transformation. In this paper, we studied the relationship between Cav-1 and other multi drug resistance associated proteins. Moreover, the author compares outcomes according to the extent of lymphadenectomy in patients with upper and middle thoracic esophageal squamous cell carcinoma without clinical cervical metastasis. The short-term and long-term data of 842 consecutive patients who underwent esophagectomy with two-field lymphadenectomy (2FL) or three-field lymphadenectomy (3FL) between February 2005 and July 2013 were retrospectively reviewed. If postoperative infection occurred, according to susceptibility test results, patients were given sensitive antibiotics. The yield of lymph nodes harvested was higher in the 3FL group than in 2FL (P=0.000). There was less blood loss (P =0.000), shorter operative time (P=0.000) less post-operative analgesia needed (P=0.000) and earlier hospital discharge (P =0.000) in 2FL than in 3FL.Overall morbidity was similar in the two groups. However, the rate of major complications was higher after 3FL versus 2FL (P=0.015). There was no 30-day mortality in 2FL and 3FL. The 5-year survival (2FL 35% vs 3FL 38%; P=0.297) and disease-free 5-year survival (2FL 26% vs 3FL 21%; P=0.106) were comparable between the two groups. In univariate analyses, extent of lymphadenectomy was not related to overall 5-year survival. Current results indicated that 2FL may be the preferred lymphadenectomy for upper and middle thoracic esophageal squamous cell carcinoma without clinical cervical metastasis.