Esophageal Cancer Patients with Less Lymph Node Dissection May Have Better Prognosis

Background: China is a high incidence area of esophageal cancer. Esophageal squamous cell carcinoma recurrence and mortality rates are relatively high. Recent studies show that the recurrence rate remains very high even through the implementation of lymph node expanding dissection. Methods and Results: In order to study the relationship between lymph node dissection number and survival of the patients with esophageal squamous cell carcinoma, 407 cases of esophageal cancer are selected in the First Affiliated Hospital of Xi’an Jiaotong University from January 2009 to June 2013. There were 15 cases without surgery, while the rest of the 392 patients were post-operation in follow-up. 54 patients were lost in follow-up, and the rate was 13.8%. Finally, there were 338 patients entered into our research. The median age was 58 (37 - 81), males accounted for 79%. The number of lymph node dissection is for a total of 2091, and a median of 5. Positive lymph nodes are 400, while the total positive rate is 19.1%. Conclusion: The number of lymph node dissection is divided into 3 groups that are 0 to 6, 7 to 11, 12 or more into three grades, and reduced number of lymph node dissection may prolong the survival (P < 0.05). The number of lymph node dissection should be as less as possible unless there is definitely positive lymph node metastasis.

背景：中国是食管癌高发地区。食管鳞状细胞癌的复发率和死亡率相对较高。近期研究表明，即使实施淋巴结扩大清扫，复发率仍然很高。 方法与结果：为研究食管鳞状细胞癌患者淋巴结清扫数目与生存之间的关系，选取2009年1月至2013年6月在西安交通大学第一附属医院的407例食管癌患者。其中15例未手术，其余392例患者术后进行随访。54例患者失访，失访率为13.8%。最终有338例患者纳入本研究。中位年龄为58岁（37 - 81岁），男性占79%。淋巴结清扫总数为2091个，中位数为5个。阳性淋巴结为400个，总阳性率为19.1%。 结论：将淋巴结清扫数目分为0 - 6、7 - 11、12及以上3组，减少淋巴结清扫数目可能会延长生存期（P < 0.05）。除非明确有淋巴结转移阳性，否则淋巴结清扫数目应尽可能少。