Evaluation of Cervical and Extended Upper Mediastinal Lymph Node Dissection for Thoracic Esophageal Cancer in Relation to Quality of Life

Katsu Hirayama, Tetsuro Nishihira, Michihiko Kitamura, Shozo Mori

The Second Department of Surgery, Tohoku University School of Medicine

Cervical and extended upper mediastinal lymph node dissection for thoracic esophageal carcinoma was evaluated in relation to the quality of life. During the period from 1986 through 1988, 89 thoracic esophageal carcinoma were resected in our department with R-II or R-III lymph node dissection through right thoracotomy. Such extended lymphadenectomy was compard with the conventional lymphadenectomy in regard to postoperative pulmonary function and performance status. Eleven of the 89 patients underwent extended lymphadenectomy while the others underwent the conventional lymphadenectomy. There were no direct operative deaths in either group. Mucosal changes in the trachea and bronchi were somewhat more pronounced in the extended lymphadenectomy group than in the conventional lymphadenectomy group, although there was no significant difference. On the other hand, the damage to the cough reflex and the incidence of temporary recurrent laryngeal nerve palsy were significantly higher in the extended lymphadenectomy group. However, there was no difference in the incidence of pulmonary complications between the two groups. Patients surviving more than 6 months after the operation were asked about their life style, via a questionaire. There were no differences in performance status and dietary habits betweent he two groups. Furthermore, the pulmonary function of patients with extended lymphadenectomy was somewhat better than in those with conventional lymphadenectomy long after the operation. Although extended lymphadenectomy causes great surgical stress, these results suggest that a high value should be placed on extended lymphadenectomy in relation to the quality of life.

Key words
cervical and extended upper mediastinal lymph node dissection for thoracic esophageal cancer, Quality of life of esophageal cancer patients, respiratory function after radical operation for thoracic esophageal cancer

Reprint requests
Katsu Hirayama The Second Department of Surgery, Tohoku University School of Medicine
1-1 Seiryo-cho, Aoba-ku, Sendai, 980 JAPAN

Accepted
November 8, 1989

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