[Clinical value of para-recurrent laryngeal nerve lymphadenectomy for middle XXXX ].

@entity1 @entity1721 @entity3
OBJECTIVE: To analyze the pattern of lymphatic @entity3 in middle @entity1721 (ESCC) with different T staging and to investigate the clinical value of para-recurrent laryngeal nerve lymphadenectomy. METHODS: Clinicopathological data of 717 @entity1 with middle thoracic ESCC undergoing Mckeown esophagectomy plus three-field lymph node dissection in Fujian Provincial Hospital from January 1999 to December 2007 were analyzed retrospectively. Lymph node metastatic rates of different T stages were calculated. Clinical value of each station lymphadenectomy, especially the para-recurrent laryngeal nerve lymphadenectomy, was evaluated by the efficacy index(EI, cross product of one station metastatic rate and 5-year survival of @entity1 with positive lymph nodes of above station). RESULTS: Rates of lymph node @entity3 were 29.0%(18/62), 61.1%(91/149) and 64.8%(328/506) in stage T1, T2 and T3 @entity1 respectively. Despite T staging, metastatic rates of right para-recurrent laryngeal nerve lymph node(rRLN LN) were 21.0% (13/62), 28.9%(43/149) and 29.4%(149/506) in stage T1, T2 and T3 @entity1 respectively, which was the most common among all lymph node stations. Metastatic rates of left para-recurrent laryngeal nerve lymph node(lRLN LN) were the second, with 8.1%(5/62), 17.4%(26/149) and 24.7%(125/506) in stage T1, T2, T3 @entity1 respectively. Follow-up period lasted more than 5 years. The 5-year survival rates of positive rRLN LN were 53.8%, 39.5% and 32.2% in stage T1, T2 and T3 @entity1 respectively, whose EI values were 11.3, 11.4 and 9.5 respectively. The 5-year survival rates of positive lRLN LN were 40.0%, 34.6% and 40.0% in stage T1, T2 and T3 @entity1 respectively, whose EI values were 3.2, 6.0 and 9.9 respectively. CONCLUSIONS: Bilateral para-recurrent laryngeal nerve lymph nodes are the common sites of @entity3 in middle @entity1721 . Right para-recurrent laryngeal nerve lymphadenectomy is of high clinical value despite the T staging. Left para-recurrent laryngeal nerve lymphadenectomy has better efficacy in stage T2 and T3 @entity1 , but is limited in stage T1 @entity1 .
