复发性喉返神经淋巴结清扫术治疗食管鳞癌患者的临床转归。

Clinical outcome of patients after recurrent laryngeal nerve lymph node dissection for oesophageal squamous cell carcinoma.

机构信息

Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.

School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

出版信息

Interact Cardiovasc Thorac Surg. 2022 Feb 21;34(3):393-401. doi: 10.1093/icvts/ivab293.

OBJECTIVES

Recurrent laryngeal nerve lymph node dissection (LND) has been incorporated into oesophagectomy for patients with oesophageal squamous cell carcinoma, but with uncertain oncological efficacy.

METHODS

The data of patients with oesophageal squamous cell carcinoma, including who underwent upfront surgery (surgery group) and those who received neoadjuvant therapy followed by surgery (neoadjuvant chemoradiotherapy group), were retrospectively examined. The overall survival (OS) and disease-free survival (DFS) were compared between patients with and without recurrent laryngeal nerve LND.

RESULTS

Among the 312 patients, no significant differences were found in 3-year OS and DFS between patients with and without recurrent laryngeal nerve LND in the entire cohort (OS: 57% vs 52%, P = 0.33; DFS: 47% vs 41%, P = 0.186), or the surgery group (n = 173, OS: 69% vs 58%, P = 0.43; DFS: 52% vs. 48%, P = 0.30) and the neoadjuvant chemoradiotherapy group (n = 139, OS: 44% vs 43%, P = 0.44; DFS: 39% vs 32%, P = 0.27). However, among patients with clinical positive recurrent laryngeal nerve lymph node involvement before treatment, there was significant OS and DFS differences between patients with and without recurrent laryngeal nerve LND (OS: 62% vs 33%, P = 0.029; DFS: 49% vs 26%, P = 0.031).

CONCLUSIONS

Recurrent laryngeal nerve LND is not a significant prognostic factor in patients with oesophageal squamous cell carcinoma; however, it is associated with better outcomes in patients with pre-treatment radiological evidence of recurrent laryngeal nerve lymph node involvement.

目的

喉返神经淋巴结清扫术（LND）已被纳入食管鳞癌的食管癌切除术，但疗效不确定。

方法

回顾性分析了接受 upfront 手术（手术组）和新辅助放化疗后手术（新辅助放化疗组）的食管鳞癌患者的临床资料。比较了有和无喉返神经 LND 的患者的总生存（OS）和无病生存（DFS）。

结果

在 312 例患者中，整个队列（OS：57% vs 52%，P=0.33；DFS：47% vs 41%，P=0.186）或手术组（n=173，OS：69% vs 58%，P=0.43；DFS：52% vs. 48%，P=0.30）和新辅助放化疗组（n=139，OS：44% vs 43%，P=0.44；DFS：39% vs 32%，P=0.27）中，有和无喉返神经 LND 的患者 3 年 OS 和 DFS 无显著差异。然而，在治疗前有临床阳性喉返神经淋巴结受累的患者中，有和无喉返神经 LND 的患者 OS 和 DFS 有显著差异（OS：62% vs 33%，P=0.029；DFS：49% vs 26%，P=0.031）。