[Results of surgical treatment for thoracic esophageal cancer with reference to a randomized controlled trial]

An esophagectomy with lymphadenectomy was performed on 248 patients in The Second Department of Surgery, Tohoku University Hospital from 1986 to 1992. Five year survival rate of 211 patients who underwent curative operation (RO) was 53.1%, however that of 33 patients undergone non-curative operation (R1 and R2) was 8.0%. The operative death was only one (0.4%) in this series. In order to clarify the efficacy of the extensive lymphadenectomy, a randomized controlled trial was performed during the same period. Five year survival rate of extensive lymphadenectomy group (n = 23) was 61.1%, however that of conventional lymphadenectomy group (n = 22) was 48.4%. There were some metastatic nodes in the left upper mediastinum or in the neck where could not be dissected through the conventional lymphadenectomy. These results indicate that the extensive lymphadenectomy for thoracic esophageal cancer can be safely performed and may contribute to improvement of survival rate after surgery.