Three-Field Lymph Node Dissection for Cancer of the Esophagus
Three-Field Lymph Node Dissection for Cancer of the Esophagus is a topic covered in the Pearson's General Thoracic.
To view the entire topic, please log in or purchase a subscription.
STS Cardiothoracic Surgery E-Book from The Society of Thoracic Surgeons provides expert guidance for Cardiac and Thoracic Surgery. Sections include Pearson’s General Thoracic, Esphageal, Adult Cardiac, and Pediatric and Congenital Cardiac Surgery. Explore these free sample topics:
-- The first section of this topic is shown below --
Key Points
- Three-field lymph node dissection for squamous cell cancer of the esophagus was pioneered by Japanese surgeons. Such an extended resection clearly shows that 25% to 40% of patients have occult metastases to the recurrent laryngeal and/or deep cervical nodes.
- Western experience with this technique is limited to just a handful of centers where adenocarcinoma is the predominant cell type. The prevalence of occult nodal metastases to the recurrent laryngeal and/or cervical nodes in esophageal adenocarcinoma is 20% to 30% and can be predicted by tumor location, depth of invasion, and by nodal metastatic burden
- In experienced hands, three-field lymph node dissection can be performed safely with a hospital mortality of less than 5% and with only slightly increased morbidity compared to two-field dissections.
- In the absence of adequately powered randomized trials comparing two- and three-field dissection, the existing retrospective data suggest that dissection of the “third field” (the recurrent laryngeal and/or cervical nodes) may improve survival of patients with squamous cell carcinoma. This is supported by comprehensive meta-analyses. In patients with adenocarcinoma, the procedure results in optimal nodal staging information; however, its impact on survival is unclear.
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Key Points
- Three-field lymph node dissection for squamous cell cancer of the esophagus was pioneered by Japanese surgeons. Such an extended resection clearly shows that 25% to 40% of patients have occult metastases to the recurrent laryngeal and/or deep cervical nodes.
- Western experience with this technique is limited to just a handful of centers where adenocarcinoma is the predominant cell type. The prevalence of occult nodal metastases to the recurrent laryngeal and/or cervical nodes in esophageal adenocarcinoma is 20% to 30% and can be predicted by tumor location, depth of invasion, and by nodal metastatic burden
- In experienced hands, three-field lymph node dissection can be performed safely with a hospital mortality of less than 5% and with only slightly increased morbidity compared to two-field dissections.
- In the absence of adequately powered randomized trials comparing two- and three-field dissection, the existing retrospective data suggest that dissection of the “third field” (the recurrent laryngeal and/or cervical nodes) may improve survival of patients with squamous cell carcinoma. This is supported by comprehensive meta-analyses. In patients with adenocarcinoma, the procedure results in optimal nodal staging information; however, its impact on survival is unclear.
There's more to see -- the rest of this topic is available only to subscribers.
Last updated: April 15, 2020
Citation
Altorki, Nasser K, and Brendon Stiles. "Three-Field Lymph Node Dissection for Cancer of the Esophagus." Pearson's General Thoracic Surgery. STS Cardiothoracic Surgery E-Book, Chicago: Society of Thoracic Surgeons, 2020. STS Surgery, ebook.sts.org.
Altorki NK, Stiles B. Three-Field Lymph Node Dissection for Cancer of the Esophagus. In: Darling GE, Baumgartner WA, Jacobs JP, eds. Pearson's General Thoracic Surgery. STS Cardiothoracic Surgery E-Book. Chicago: Society of Thoracic Surgeons; 2020. ebook.sts.org. Accessed March 29, 2023.
Altorki, N. K., & Stiles, B. (2020). Three-Field Lymph Node Dissection for Cancer of the Esophagus. In Darling, G., Baumgartner, W., & Jacobs, J. (Eds.), Pearson's General Thoracic Surgery. STS Cardiothoracic Surgery E-Book. Chicago: Society of Thoracic Surgeons. ebook.sts.org
Altorki NK, Stiles B. Three-Field Lymph Node Dissection for Cancer of the Esophagus [Internet]. In: Darling GE, Baumgartner WA, Jacobs JP, editors. Pearson's General Thoracic Surgery. STS Cardiothoracic Surgery E-Book. Chicago: Society of Thoracic Surgeons; 2020. [cited 2023 March 29]. Available from: ebook.sts.org.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Three-Field Lymph Node Dissection for Cancer of the Esophagus
ID - 1418564
ED - Jacobs,J,
ED - Darling,Gail,
ED - Baumgartner,William,
Y1 - 2020/04/15/
BT - Pearson's General Thoracic
UR - https://ebook.sts.org/sts/view/Pearsons-General-Thoracic/1418564/4/Three_Field_Lymph_Node_Dissection_for_Cancer_of_the_Esophagus
PB - Chicago: Society of Thoracic Surgeons
DB - STS Surgery
DP - Unbound Medicine
ER -