Erschienen in:
05.04.2021 | Thoracic Oncology
Unlocking Better Survival for Esophageal Cancer Patients: Is Thoracic Duct Resection the Key?
verfasst von:
Haichuan Hu, MD, PhD, Haiquan Chen, MD, PhD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 8/2021
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Excerpt
Esophagectomy plays a distinct role in a multimodality treatment plan for esophageal squamous cell carcinoma (ESCC). However, whether and how a standard procedure should be defined to increase anatomic feasibility and enhance the control of local recurrence and distal metastasis are still subject to debate. Uniquely, ESCC lymph node metastasis occurs both vertically (proximal esophagus drains through recurrent laryngeal nodes to supraclavicular nodes, and the distal esophagus drains into paracardial nodes) and horizontally (para-esophageal lymph node metastasis in the middle and lower mediastinum).
1 Therefore, resection of the thoracic duct (TD) used to be a critical procedure in certain medical centers to achieve a more complete mediastinal lymph node dissection. However, this procedure has become infrequently applied given the concerns of perioperative complications and the wide use of minimally invasive surgical approaches. More importantly, there has been limited knowledge to show whether TD resection can provide a definitive benefit to improve patients’ long-term outcomes. …
