Efficacy of surgical management for esophageal squamous cell carcinoma in pathological stage T1b

Duojie Zhu; Cheng Wang; Xiaoping Wei; Jianbao Yang; Yuqi Meng; Tieniu Song; Shaobo Zhang; Haiming Feng; Tao Jing; Peng Jiang; Bin LI

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Efficacy of surgical management for esophageal squamous cell carcinoma in pathological stage T1b

VernacularTitle:病理T1b期食管鳞状细胞癌外科治疗的结果分析
Author: Duojie ZHU ¹ ; Cheng WANG ¹ ; Xiaoping WEI ¹ ; Jianbao YANG ¹ ; Yuqi MENG ¹ ; Tieniu SONG ¹ ; Shaobo ZHANG ¹ ; Haiming FENG ¹ ; Tao JING ¹ ; Peng JIANG ¹ ; Bin LI ¹
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1. Department of Thoracic Surgery, Lanzhou University Second Hospital, Lanzhou University Second Clinical Medical College, Lanzhou, 730030, P.R.China
Publication Type:Journal Article
Keywords: Esophageal squamous cell cancer; pathological stage T1b; esophagectomy; long-term survival; surgery
From: Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2021;28(06):696-700
CountryChina
Language:Chinese
Abstract: Objective To investigate the prognostic survival status and influence factors for surgical treatment of esophageal squamous cell carcinoma (ESCC) in pathological stage T1b (pT1b). Methods The patients with ESCC in pT1b undergoing Ivor-Lewis or McKeown esophagectomy in Lanzhou University Second Hospital from 2012 to 2015 were collected, including 78 males (78.3%) and 17 females (21.7%) with an average age of 61.4±7.4 years. Results The most common postoperative complications were pneumonia (15.8%), anastomotic leakage (12.6%) and arrhythmia (8.4%). Ninety-three (97.9%) patients underwent R0 resection, with an average number of lymph node dissections of 14.4±5.6. The rate of lymph node metastasis was 22.1%, and the incidence of lymph vessel invasion was 13.7%. The median follow-up time was 60.4 months, during which 25 patients died and 27 patients relapsed. The overall survival rate at 3 years was 86.3%, and at 5 years was 72.7%. Multivariate Cox regression analysis showed that lymph node metastasis (P=0.012, HR=2.60, 95%CI 1.23-5.50) and lympovascular invasion (P=0.014, HR=2.73, 95%CI 1.22-6.09) were independent risk factors for overall survival of pT1b ESCC. Conclusion Esophagectomy via right chest approach combined with two-fields lymphadenectomy is safe and feasible for patients with pT1b ESCC. The progress of pT1b ESCC with lymph node metastasis or lymphovascular invasion is relatively poor.