Treatment outcomes of elective neck dissection in intrathoracic esophageal carcinoma

Abstract

Abstract OBJECTIVE: We investigated the outcomes of elective neck dissection in intrathoracic esophageal squamous cell carcinoma. PATIENTS and METHODS: From January 2016 to December 2022, a total of 195 patients underwent esophagectomy for esophageal carcinoma at our institution. Among them, 21 patients who underwent esophagectomy and elective neck dissection (both neck level IV) for intrathoracic esophageal squamous cell carcinoma were enrolled. RESULTS: Of the 21 patients, 19 patients were male, and 2 patients were female. A total of 11 patients received treatment before surgery, and all of them received concurrent chemoradiotherapy (CCRT). As a result of elective neck dissection at both neck level IV, neck occult metastasis of esophageal squamous cell carcinoma was diagnosed in 3 cases (14.3%), all of which involved left neck lymph nodes. Preoperative CCRT, T stage, and N stage were risk factors for neck occult metastasis of intrathoracic esophageal squamous cell carcinoma (p < 0.05). A total of 16 patients (76.2%) had been under follow-up without disease recurrence after the completion of treatment. However, 3 patients died of esophageal squamous cell carcinoma, and 2 patients were alive with esophageal carcinoma. The follow-up period was 19.2 ± 18.4 months. CONCLUSION: Three-field lymph node dissection may be necessary for intrathoracic esophageal squamous cell carcinoma. Preoperative CCRT, T stage, and N stage were risk factors for neck occult metastasis of intrathoracic esophageal squamous cell carcinoma.