食管鳞状细胞癌2.5野区和3野区淋巴结清扫的远期疗效比较

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2025-09-09 DOI:10.1016/j.ejso.2025.110435

Maohui Chen , Taidui Zeng , Yizhou Huang , Shuliang Zhang , Chun Chen , Bin Zheng

{"title":"食管鳞状细胞癌2.5野区和3野区淋巴结清扫的远期疗效比较","authors":"Maohui Chen , Taidui Zeng , Yizhou Huang , Shuliang Zhang , Chun Chen , Bin Zheng","doi":"10.1016/j.ejso.2025.110435","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>Previous studies demonstrated that the mesoesophageal suspension technique is safe and effective for thoracoscopic lymph node dissection in esophageal squamous cell carcinoma (ESCC), but direct comparison with 3-field dissection is lacking. This study aimed to compare 2.5- and 3-field lymph node dissections in terms of survival benefits, recurrence patterns, and complications in patients with ESCC.</div></div><div><h3>Methods</h3><div>This was a retrospective study of patients with ESCC who underwent 2.5- or 3-field lymph node dissection (FLD). The outcomes included 30-day mortality, postoperative complications, overall survival (OS), disease-free survival (DFS), and recurrence pattern.</div></div><div><h3>Results</h3><div>A total of 353 patients with ESCC were included in this study. After propensity score matching, the frequency of all complications (27.8 % vs. 18.3 %, P = 0.072), recurrent laryngeal nerve injury (5.6 % vs. 0.8 %, P = 0.033) and respiratory complications (19.8 % vs. 11.9 %, P = 0.084) was higher in the 3-field group compared with the 2.5-field group. Smaller number of dissected lymph nodes (median, 31.5 vs. 41, P < 0.001) but comparable number of metastatic lymph nodes (median, 0 vs. 1, P = 0.143) was found in the 2.5-field group compared with the 3-field group. The rate of positive supraclavicular lymph nodes was 1.6 % in the 3-field group. There were no differences OS and DFS between the two groups, with median OS and DFS not reached in both groups. Recurrence pattern of all stage patients was similar between the two groups.</div></div><div><h3>Conclusion</h3><div>The 2.5- and 3-FLD have comparable survival benefits for patients with ESCC, while the 2.5-FLD has a lower risk of complications.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 11","pages":"Article 110435"},"PeriodicalIF":2.9000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of long-term outcomes of 2.5- and 3-field lymph node dissections for esophageal squamous cell carcinoma\",\"authors\":\"Maohui Chen , Taidui Zeng , Yizhou Huang , Shuliang Zhang , Chun Chen , Bin Zheng\",\"doi\":\"10.1016/j.ejso.2025.110435\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><div>Previous studies demonstrated that the mesoesophageal suspension technique is safe and effective for thoracoscopic lymph node dissection in esophageal squamous cell carcinoma (ESCC), but direct comparison with 3-field dissection is lacking. This study aimed to compare 2.5- and 3-field lymph node dissections in terms of survival benefits, recurrence patterns, and complications in patients with ESCC.</div></div><div><h3>Methods</h3><div>This was a retrospective study of patients with ESCC who underwent 2.5- or 3-field lymph node dissection (FLD). The outcomes included 30-day mortality, postoperative complications, overall survival (OS), disease-free survival (DFS), and recurrence pattern.</div></div><div><h3>Results</h3><div>A total of 353 patients with ESCC were included in this study. After propensity score matching, the frequency of all complications (27.8 % vs. 18.3 %, P = 0.072), recurrent laryngeal nerve injury (5.6 % vs. 0.8 %, P = 0.033) and respiratory complications (19.8 % vs. 11.9 %, P = 0.084) was higher in the 3-field group compared with the 2.5-field group. Smaller number of dissected lymph nodes (median, 31.5 vs. 41, P < 0.001) but comparable number of metastatic lymph nodes (median, 0 vs. 1, P = 0.143) was found in the 2.5-field group compared with the 3-field group. The rate of positive supraclavicular lymph nodes was 1.6 % in the 3-field group. There were no differences OS and DFS between the two groups, with median OS and DFS not reached in both groups. Recurrence pattern of all stage patients was similar between the two groups.</div></div><div><h3>Conclusion</h3><div>The 2.5- and 3-FLD have comparable survival benefits for patients with ESCC, while the 2.5-FLD has a lower risk of complications.</div></div>\",\"PeriodicalId\":11522,\"journal\":{\"name\":\"Ejso\",\"volume\":\"51 11\",\"pages\":\"Article 110435\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-09-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ejso\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0748798325008637\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ejso","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0748798325008637","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的以往的研究表明食管间系悬浮技术在胸腔镜下食管鳞癌（ESCC）淋巴结清扫中是安全有效的，但缺乏与三野区清扫的直接比较。本研究旨在比较ESCC患者2.5野区和3野区淋巴结清扫的生存获益、复发模式和并发症。方法回顾性研究接受2.5野区或3野区淋巴结清扫（FLD）的ESCC患者。结果包括30天死亡率、术后并发症、总生存期（OS）、无病生存期（DFS）和复发模式。结果共纳入353例ESCC患者。倾向评分匹配后，3场组的所有并发症（27.8% vs. 18.3%, P = 0.072）、喉返神经损伤（5.6% vs. 0.8%, P = 0.033）和呼吸系统并发症（19.8% vs. 11.9%, P = 0.084）发生率高于2.5场组。与3野区组相比，2.5野区组的淋巴结清扫数量较少（中位数，31.5 vs. 41, P < 0.001），但转移性淋巴结数量相当（中位数，0 vs. 1, P = 0.143）。三野组锁骨上淋巴结阳性率为1.6%。两组间OS和DFS无差异，两组均未达到中位OS和DFS。两组各分期患者的复发模式相似。结论：对于ESCC患者，2.5- fld和3-FLD具有相当的生存获益，而2.5- fld的并发症风险较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Comparison of long-term outcomes of 2.5- and 3-field lymph node dissections for esophageal squamous cell carcinoma

Objectives

Previous studies demonstrated that the mesoesophageal suspension technique is safe and effective for thoracoscopic lymph node dissection in esophageal squamous cell carcinoma (ESCC), but direct comparison with 3-field dissection is lacking. This study aimed to compare 2.5- and 3-field lymph node dissections in terms of survival benefits, recurrence patterns, and complications in patients with ESCC.

Methods

This was a retrospective study of patients with ESCC who underwent 2.5- or 3-field lymph node dissection (FLD). The outcomes included 30-day mortality, postoperative complications, overall survival (OS), disease-free survival (DFS), and recurrence pattern.

Results

A total of 353 patients with ESCC were included in this study. After propensity score matching, the frequency of all complications (27.8 % vs. 18.3 %, P = 0.072), recurrent laryngeal nerve injury (5.6 % vs. 0.8 %, P = 0.033) and respiratory complications (19.8 % vs. 11.9 %, P = 0.084) was higher in the 3-field group compared with the 2.5-field group. Smaller number of dissected lymph nodes (median, 31.5 vs. 41, P < 0.001) but comparable number of metastatic lymph nodes (median, 0 vs. 1, P = 0.143) was found in the 2.5-field group compared with the 3-field group. The rate of positive supraclavicular lymph nodes was 1.6 % in the 3-field group. There were no differences OS and DFS between the two groups, with median OS and DFS not reached in both groups. Recurrence pattern of all stage patients was similar between the two groups.

Conclusion

The 2.5- and 3-FLD have comparable survival benefits for patients with ESCC, while the 2.5-FLD has a lower risk of complications.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.