Surgical Treatment for Early Esophageal Squamous Cell Carcinoma


More studies are needed to clarify treatments and prognosis of early esophageal squamous cell carcinoma(ESCC). This retrospective study was designed to review the outcome of surgical treatment for early ESCC,evaluate the results of a left thoracotomy for selected patients with early ESCC, and identify factors affectinglymph node metastases and survival. The clinicopathological data of 228 patients with early ESCC who underwenttransthoracic esophagectomy with lymphadenectomy without preoperative adjuvant treatment were reviewed.The χ2 test or Fisher’s exact test were used to detect factors related to lymph node metastasis. Univariate andmultivariate analyses were performed to identify prognostic factors. There were 152 males and 76 females witha median age of 55 years. Two hundred and eight patients underwent a left thoracotomy, and the remaining20 patients with lymph nodes in the upper mediastinum more than 5 mm in short-axis diameter by computedtomography scan underwent a right thoracotomy. No lymph node metastasis was found in the 18 patients withcarcinoma in situ, while lymph node metastases were detected in 1.6% (1/62) of patients with mucosal tumoursand 18.2% (27/148) of patients with submucosal tumours. Only 7 patients showed upper mediastinal lymph nodemetastases in the follow-up. The 5- and 10-year overall survival rates were 81.4% and 70.1%, respectively. Onlyhistologic grade (P<0.001) and pT category (P=0.001) significantly correlated with the presence of lymph nodemetastases. In multivariate analysis, only histologic grade (P=0.026) and pT category (P=0.008) were independentprognostic factors. A left thoracotomy is acceptable for selected patients with early ESCC. Histologic grade andpT category affected the presence of lymph node metastases and were independent prognostic factors for earlyESCC.