Interet de la lymphadenectomie etendue dans le cancer du bas oesophage et du cardia

Translated title of the contribution: Contribution of wide node dissection in cancers of the lower esophagus and cardia

A. Peracchia, L. Bonavina, R. Incarbone, B. Chella

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Between 1980 and 1997, 1194 patients with a malignant tumor of the lower esophagus have been observed and treated in our Institution. There were 555 patients (46.5 %) presenting with squamous-cell carcinoma, 101 (8.5 %), with Barrett's adenocarcinoma and 538 (45 %) with cardia adenocarcinoma. Most patient underwent a transthoracic esophagectomy with esophagogastroplasty; transhiatal approach was mainly reserved to high-risk patients. Over the past two years sixty-three patients (42 with adenocarcinoma and 21 with squamous cell carcinoma) underwent enlarged mediastinal lymphadenectomy. Three patients (4.7 %) died post-operatively: one sepsis, in pulmonary embolism and one myocardial infarction. Four patients (6.3 %) developed pulmonary complications; no patient had recuriential palsy. Pathologic exam revealed 1342 nodes (807 thoracic and 827 abdominal). Twenty patients (31.7 %) had mediastinal nodal metastases, of which 8 in the upper mediastinum. Median follow-up was 19 months (2-36 months). Seven of the sixteen patients with recurrent disease (12 sistemic, 3 mediastinal and 1 anastomotic) died. The number of metastatic nodes increased with serial section and even more with immunohistochemical staining technique (from 11.7 % to 13 % to 15.5 %, respectively). Two patients were up-staged from M0 to M1 because of peripancreatic nodal micrometastases. We conclude that enlarged mediastinal lymphadenectomy allowed to detect upper mediastinal lymph node metastases in 12.8 % of patients without increasing post-operative complication rate. A longer follow-up is required to evaluate the impact on long term survival.

Original languageFrench
Pages (from-to)209-213
Number of pages5
JournalJournal de Chirurgie
Volume134
Issue number5-6
Publication statusPublished - Nov 1997

Fingerprint

Cardia
Esophageal Neoplasms
Dissection
Adenocarcinoma
Lymph Node Excision
Squamous Cell Carcinoma
Neoplasm Metastasis
Neoplasm Micrometastasis
Esophagectomy
Mediastinum
Pulmonary Embolism
Paralysis
Esophagus
Sepsis
Thorax
Lymph Nodes
Myocardial Infarction

Keywords

  • Adenocarcinoma
  • Carcinoma
  • Cardia
  • Esophagus
  • Lymphadenectomy
  • Squamous-cell

ASJC Scopus subject areas

  • Surgery

Cite this

Interet de la lymphadenectomie etendue dans le cancer du bas oesophage et du cardia. / Peracchia, A.; Bonavina, L.; Incarbone, R.; Chella, B.

In: Journal de Chirurgie, Vol. 134, No. 5-6, 11.1997, p. 209-213.

Research output: Contribution to journalArticle

Peracchia, A, Bonavina, L, Incarbone, R & Chella, B 1997, 'Interet de la lymphadenectomie etendue dans le cancer du bas oesophage et du cardia', Journal de Chirurgie, vol. 134, no. 5-6, pp. 209-213.
Peracchia, A. ; Bonavina, L. ; Incarbone, R. ; Chella, B. / Interet de la lymphadenectomie etendue dans le cancer du bas oesophage et du cardia. In: Journal de Chirurgie. 1997 ; Vol. 134, No. 5-6. pp. 209-213.
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