Effects of standard and total two-field lymph node dissection on prognosis of patients undergoing Esophagectomy

Objectives: To investigate the effects of standard two-field lymph node dissection (2FLND) and total 2FLND on the short-term and long-term clinical efficacy and complications of patients undergoing esophagectomy.

Methods: The clinical data of 268 patients undergoing radical Ivor-Lewis esophagectomy in our hospital from January 2008 to November 2015 were analyzed retrospectively. According to different methods of lymph node dissection (LND), the patients were divided into standard 2FLND group (n = 121) and total 2FLND group (n = 147). The LND status, postoperative complications, survival rate and lymph node recurrence of the two groups were analyzed.

Results: Lymph node metastasis rate showed no statistically significant difference between the standard 2FLND group and the total 2FLND group (71.1% and 63.3%, respectively, P > 0.05). The incidence of postoperative complications was 5.8% (7/121) in the standard 2FLND group, which was lower than that in the total 2FLND group [17.0% (25/147)], with a statistically significant difference (χ2 = 7.948, P < 0.01). The 5-year survival rate of the standard 2FLND group and the total 2FLND group was 29.8% and 28.6%, respectively, without statistically significant difference (χ2 = 0.005, P > 0.05). The lymph node recurrence rate in the standard 2FLND group was 41.3% (50/121), which was higher than 19.0% (28/147) of the total 2FLND group (χ2 = 15.959, P < 0.01).

Conclusion: Compared with standard 2FLND, total 2FLND does not improve the postoperative survival of patients with esophageal carcinoma, and the risk of complications is higher.