Evaluation of 3-field Lmyph Node Dissection for Aged Patients with Thoracic Esophageal Carcinoma

Toshitaka Fukumoto, Kazunobu Tokuda, Michiyo Asatani, Mitsuhisa Sagara, Kazusada Shirao, Chikara Kusano, Shouji Natsugoe, Masamichi Baba, Heiji Yoshinaka, Takashi Aikou

First Department of Surgery, Faculty of Medicine, Kagoshima University

Since 1983, esophagectomy with 3-field lymph node dissection has been performed for thoracic esophageal carcinoma in our surgery clinic. Recently, the number of aged patients with esophageal carcinoma has increased. In this series, we investigated the suitability of 3-field lymph node dissectin for aged patients. During the period from January 1983 to December 1992, a total of 251 patients with thoracic esophageal carcinoma were curatively operated in our clinic. They were divided into two groups, an aged-group (over 70 years old, 65 cases) and a non-aged-group (under 69 years old, 186 cases). 1) A highly incidence of preoperative disorder was noted in the aged group. 2) There was no peculiar complication in aged patients, but, complications were more frequent in the 3-field dissection group than the 2-field dissection group. Severe complications like perforation of the trachea occurred in 3-field lymph node dissection group. 3) The hospital mortality rate was similar in both groups. 4) The relative 5-year survival rates of patients with 2-field lymph node dissection were similar in the two groups. The relative 5-year survival rates of aged patients with 3-field lymph node dissection was 8.0%, significantly lower than the 35.9% in non-aged patients. Considering the results, it is better to choose the surgery with rational lymph node dissection for aged patients with thoracic esophageal carcinoma.

Key words
aged patient, thoracic esophageal carcinoma, 3-field lymph node dissection, postoperative complication

Reprint requests
Toshitaka Fukumoto First Department of Surgery, Faculty of Medicine, Kagoshima University
8-35-1 Sakuragaoka, Kagoshima, 890 JAPAN

Accepted
January 11, 1995

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