China News Online, August 11 (Chen Jing Wang Guangzhao) China is a country with a high incidence of esophageal cancer. Surgery is the main means to cure esophageal cancer and improve the quality of life of patients. Among them, thorough cleaning of the lymph nodes around the esophagus is to reduce esophageal cancer. The key operation of recurrence and metastasis.
The reporter learned on the 11th that a large-scale study conducted by the team of Professor Chen Haiquan from the Department of Thoracic Surgery of Fudan University Cancer Hospital has taken the lead in clearly defining the scope of lymph node dissection for esophageal cancer in the international academic community.
This phase III clinical study found that the overall survival rate and disease-free survival rate of esophageal patients who underwent "two-field" lymph node dissection were compared with patients with esophageal cancer who received "two-field" + neck area and "three-field" lymph node dissection. There is no significant difference.
It is reported that the "two fields" include the middle and lower mediastinum, upper abdomen, and the neck-thoracic junction; the "three fields" means "the two fields + the neck".
The research results were recently published in the official journal of the International Association for the Study of Lung Cancer, "Journal of Thoracic Oncology".
Clinical data shows that more than half of patients with esophageal cancer have lymph node metastasis at the time of treatment.
During esophageal cancer surgery, doctors usually perform lymph node dissection in these areas to reduce the risk of recurrence and metastasis of the disease.
So, is the scope of lymph node dissection for esophageal cancer the choice of "two-field" or "three-field" lymph node dissection?
This problem has always been controversial, and thoracic surgeons in different medical centers hold different views.
It is understood that in the expert review that was invited for the official journal of the American Society of Thoracic Surgery, the Journal of Thoracic and Cardiovascular Surgery, the authoritative expert in the field of esophageal cancer treatment and Professor Nasser Altorki from New York Presbyterian Hospital highly praised Professor Chen Haiquan’s team for esophageal cancer. The study of lymph node dissection, and it is believed that this study provides the most authoritative and decisive conclusion in the field of lymph node dissection for esophageal cancer, which is also of great significance to scholars in Western countries.
The esophagus is the digestive organ that connects the pharynx and stomach.
According to Dr. Li Bin from the Cancer Hospital of Fudan University, due to the abundant lymphatic vascular network in and around the esophageal tube wall, the possible lymph node metastasis of esophageal cancer also involves many areas of the neck, chest, and abdomen.
Li Bin explained that in general, the larger the range of lymph node dissection for esophageal cancer, the better the surgical effect, and the lower the risk of recurrence and metastasis for patients. At the same time, expanded lymph node dissection will also increase the risk of complications and affect the patient’s health. Quality of Life.
The large-scale clinical research conducted by the team led by Professor Chen Haiquan enrolled hundreds of patients in more than three years.
The postoperative results showed that the incidence of postoperative complications was similar in the two groups.
There was no significant difference in the overall survival rate and disease-free survival rate between the two groups. The 5-year overall survival rate of the two groups was 63%; the 5-year disease-free survival rate in the “three-field” group was 53%, and the 5-year disease-free survival rate in the “two-field group” was 59 %.
The epidemiological data of esophageal cancer are different in eastern and western countries.
The esophageal cancer patients in East Asian countries are mainly squamous cell carcinoma, and the esophageal cancer patients in Europe and America are mostly adenocarcinoma.
Are the research results of Professor Chen Haiquan's team useful in Western countries?
Based on the cutting-edge data of previous countries and the research results of Professor Chen Haiquan’s team this time, Professor Altoiki believes that among Western patients with esophageal cancer and adenocarcinoma, the survival of patients with “three-field” and “two-field” lymph node dissection surgery is extremely good. It may also be similar.
At the same time, Professor Altoiki emphasized in the research review: "During esophageal cancer surgery, whether it is'three-field' or'two-field' lymph node dissection, it puts forward higher requirements for thorough and standardized lymph node dissection, because this can be a problem for esophageal cancer. The patient brings a definite improvement in survival.” (End)