Prognostic value of right upper mediastinal lymphadenectomy in Sweet procedure for esophageal cancer

Abstract

Results: As for the prognostic role of RUMLND, patients treated with MS tended to obtain higher 5-year survival rate than patients treated with SS in univariate analysis (48.1% vs. 37.4%). Moreover, in multivariate analysis, MS yielded significant higher 5-year survival rate compared with SS (P=0.041). In addition, subgroup analyses of the survival between the MS and SS patients by detailed stratifications demonstrated the survival superiority in the MS group with age <60 years old, TNM stage III, number of lymph node dissection (LND) ≥15, as well as no using of postoperative adjuvant treatment. Conclusions:The RUMLND in Sweet procedure is an independent prognostic factor for ESCC-MLT patients, especially for those with thoracic middle segment-located tumor, stage III or younger.

Development and validation of nomograms to intraoperatively predict metastatic patterns in regional lymph nodes in patients diagnosed with esophageal cancer

“…There are two opposite opinions about extended systematic nodal dissection. The benefit of extended systematic nodal dissection is under intense discussion [ 10 , 11 ]. Surgeons aim to identify an accurate strategy of lymph node dissection to improve prognosis and reduce the possibility of postoperative complications in patients with esophageal cancer.…”

Thoracoscopic radical esophagectomy combined with left inferior pulmonary ligament lymphadenectomy for esophageal carcinoma via the right thoracic approach

“…[11,21] In recent years, VATS radical resection of thoracic esophageal cancer via the right thoracic approach has gradually become the preferred surgical method for thoracic esophageal cancer because it can completely dissect the upper mediastinal lymph nodes, such as the left and right recurrent laryngeal nerve lymph nodes. [22][23][24] However, in clinical practice, we found that neglecting the existence of LIPLNs during the radical resection of esophageal cancer or performing incomplete dissection will increase the probability of residual cancer and the possibility of the recurrence of lymph node metastasis.…”

Chinese expert consensus on mediastinal lymph node dissection in esophagectomy for esophageal cancer (2017 edition)

“…Approaches through a right thoracic incision (Ivor Lewis and McKeown procedures) can help overcome this shortcoming. Therefore, these two procedures have gradually become the preferred approaches for thoracic esophageal cancer (11,(34)(35)(36). The Chinese Guidelines for Standardized Diagnosis and Treatment of Esophageal Cancer also recommended these procedures (37).…”

“…Some studies suggested that radical lymphadenectomy could better control local lesions, remove undetectable micrometastases, and prolong patient survival (6)(7)(8)(9)(10)(11), but others believed that the esophageal squamous cell carcinoma is a systemic disease (12) and radical lymphadenectomy would increase postoperative complications without prolonging the survival of patients (13)(14)(15). Therefore, in order to reach a consensus and to guide the clinical practice in China, the Esophageal Cancer Committee of the Chinese Anti-Cancer Association organized a group of experienced experts in the field to develop this consensus document.…”