Comparison of therapeutic efficacy between Ivor-Lewis esophagectomy and 2-incision esophagectomy via left thoracic-cervical pathway in the treatment of middle thoracic esophageal carcinoma / 肿瘤

ABSTRACT

Objective:To retrospectively evaluate the therapeutic efficacy of two different surgical approaches, Ivor-Lewis esophagectomy and 2-incision esophagectomy via left thoracic-cervical pathway, in the treatment of middle thoracic esophageal squamous cell carcinoma. Methods:One hundred and two patients from 167 patients with middle thoracic esophageal squamous cell carcinoma received Ivor-Lewis esophagectomy and another 65 patients received 2-incision esophagectomy via left thoracic-cervical pathway. The local recurrence rate of tumor and survival rate were calculated by using Kaplan-Meier method. The difference in the survival rate between the two surgical methods was analyzed by using log-rank test. The prognostic risk factors were assessed by COX regression analysis. Results:Peri-operative complications occurred in 35 patients (21.0%), in which the incidences of recurrent laryngeal nerve (RLN) injury and anastomotic leakage were higher in the left thoracic-cervical group (P0.05). The overall 5-year survival rate of the 167 patients was 34.6%. It was 36.0% in the Ivor-Lewis group and 32.3% in the left thoracic-cervical group, respectively (P>0.05). COX regression analysis revealed that pTNM staging was the independent prognostic factor [P=0.000, HR(hazard ratio)=2.69]. Conclusion:Both Ivor-Lewis esophagectomy and 2-incision esophagectomy via left thoracic-cervical pathway are feasible alternatives in the treatment of middle thoracic esophageal squmamous cell carcinoma. We should choose the rational operative method based on the patients'individual condition.