食管癌颈胸腹三区域淋巴结清扫术与预后的关系研究

[目的]探讨食管癌淋巴结转移规律及颈胸腹三区域淋巴结清扫术与预后的关系。[方法]对308例胸段食管癌采用颈、胸、腹三切口施行三区域淋巴结清扫术。[结果]颈部及上纵隔淋巴结转移率分别为57.1%和21.5%。其中胸中、上段食管癌颈部淋巴结转移率分别为39.4%、43.7%,右胸顶淋巴结转移率分别为15.0%、37.5%,气管旁淋巴结转移率分别为13.7%、25.0%。[结论]胸段食管癌的预后与肿瘤的侵及深度、分化程度、淋巴结转移个数、肿瘤的部位及患者年龄等因素密切相关,三区域淋巴结清扫术可有效提高淋巴结转移阴性和少数转移患者的生存率。

STUDY ON THE RELATIONSHIP OF THE THREE-FIELD LYMPH NODE DISSECTION ON PATIENTS WITH THORACIC ESOPHAGEAL CARCINOMA AND IST PROGNOSIS

[Objective]To assess the rules of lymph node metastasis in thoracic esophageal carcinoma and three-field lymph node dissection influences survival and its prognosis.[Methods]From 1998 to 2002,308 patients with thoracic esophageal carcinoma underwent esophagectomy through right thoracotomy and three-field lymph node dissection.[Results]The rate of patients with cearival and upper midastinal lymph node metastasis was 57.1%.Metastases were found in 21.5% of total dissected lymph nodes;in which 23.8% from neck and 33.1% from upper mediastinum.When cancer located in the upper and middle portion of esophagus,lymph node metastasis were 43.7% and 39.4% in the neck,37.5% and 15% in the upper mediastinum.[Conclusion]The results of this study indicate that carcinoma in the upper and middle portion of the esophagus has a higher rate of lymph node metastases in the neck and upper mediastinum.In order to prevent lymph node recurrence and to improve the long-term survival,lymph node dissection of three-field,particularly the neck and upper mediastinum,shoud be performed routinely.