Short-term outcomes of three- and two-field lymphadenectomy with minimally invasive esophagectomy for esophageal cancer: a propensity score-matching analysis

• Published in: Translational cancer research 2024-07, Vol.13 (7), p.3437-3445
• Main Authors: Sun, Zeng-Feng, Fan, Bo-Shi, Liu, Jun-Qiang, Di, Shou-Yin, Yue, Cai-Ying, Zhao, Jia-Hua, Wang, Ju-Si, Song, Wei-An, Lu, Jing, Zhang, Jia-Le, Gong, Tai-Qian
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2218-676X; 2219-6803; 2219-6803
• DOI: 10.21037/tcr-23-2356

Whether patients can benefit from three-field lymphadenectomy (3-FL) in minimally invasive esophagectomy (MIE) remains unclear. This study retrospectively compared short-term outcomes between 3-FL and two-field lymphadenectomy (2-FL) in MIE for patients with esophageal cancer (EC) and aimed to evaluate the clinical significance of 3-FL. There were 284 patients enrolled in the study (124 patients with 3-FL and 160 patients with 2-FL). The cases were matched based on their propensity scores using a matching ratio of 1:1, the nearest neighbor matching protocol, and a caliper of 0.02. Patients were propensity-score matched for sex, cancer location, Age-adjusted Charlson Comorbidity Index (ACCI), and neoadjuvant treatment. The short-term outcomes were postoperative complications, operation characteristics, pathology results and postoperative hospital stay. There were no significant differences in intraoperative hemorrhage, postoperative hospital stay, or postoperative complications between the 2-FL and 3-FL groups. The operation time of the two groups was significantly different (227.1±46.2 248.5±45.9 min, P=0.001); the operation time of the 3-FL group was about 20 minutes longer than that of the 2-FL group. The number of lymphatic nodes (LNs) obtained in the 3-FL group was significantly higher than that in the 2-FL group (31.3±12.9 54.6±18.0, P