Impact of subcarinal dissection on short-term outcome and survival following esophagectomy

Am J Surg. 2013 Sep;206(3):314-9. doi: 10.1016/j.amjsurg.2012.10.044. Epub 2013 Jun 27.

Abstract

Background: The purpose of this study was to investigate the impact of subcarinal dissection on short-term outcomes and survival after esophagectomy in patients with thoracic esophageal squamous cell carcinoma.

Methods: Patients without subcarinal dissection were matched randomly to patients with subcarinal dissection in a 1:1 ratio according to 5 baseline variables (gender, pathologic stage, tumor location, histologic grade, and surgical approach) that may have major impacts on short-term outcomes and survival after esophagectomy in patients with thoracic esophageal squamous cell carcinoma. Preoperative clinical characteristics, short-term outcomes, and survival after esophagectomy of the 2 groups were compared.

Results: There were 128 patients included in each group. Blood loss, postoperative pleural drainage volume, and the incidences of postoperative complications and pulmonary complications in the nondissection group were significantly less than in the dissection group. The comparison of overall survival curves and disease-free survival curves between the 2 groups showed no significant difference (P > .05).

Conclusions: Subcarinal dissection might be futile for patients with thoracic esophageal squamous cell carcinoma.

Keywords: Esophageal squamous cell carcinoma; Esophagectomy; Lymph node dissection; Subcarinal node.

MeSH terms

  • Blood Loss, Surgical / statistics & numerical data
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Chi-Square Distribution
  • China / epidemiology
  • Dissection
  • Drainage
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery*
  • Esophagectomy* / mortality
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Postoperative Complications / epidemiology
  • Survival Rate
  • Treatment Outcome