食管癌淋巴结清扫范围

Extent of lymphadenectomy for esophageal cancer

食管癌是我国常见的恶性肿瘤,对于可切除的食管肿瘤,手术仍是最主要治疗方式。目前,对于手术治疗过程中的淋巴结清扫范围仍有较大争议。一方面,彻底地进行淋巴结清扫,可以尽可能多地摘除转移淋巴结,获得精准分期,以指导下一步诊疗;另一方面,彻底地进行淋巴结清扫可能会带来更多的术后并发症,从而影响患者预后。因此,如何在肿瘤根治性所需淋巴结清扫范围或数量与可能带来的严重并发症之间获得平衡,目前尚有争论。此外,新辅助治疗后淋巴结的清扫策略是否应该有所改变也是值得探讨的问题,尤其是在新辅助治疗后完全缓解的食管癌中。本文将总结国内外关于淋巴结清扫范围或清扫程度的临床经验,以期为食管癌外科治疗中的淋巴结清扫范围提供参考。

Esophageal cancer is a common malignant tumor in China.For resectable ones,surgery is still the primary treatment.At present,the extent of lymph node dissection remains controversial.Extended lymphadenectomy makes metastatic lymph nodes more likely to be resected,which contributed to pathological staging and postoperative treatment.However,it may also increase the risk of postoperative complications and affect prognosis.Therefore,it is controversial how to balance the optimal extent/number of dissected lymph nodes for radical resection with the lower risk of severe complications.In addition,whether the lymph node dissection strategy should be modified after neoadjuvant therapy needs to be investigated,especially for patients who have a complete response to neoadjuvant therapy.Herein,we summarize the clinical experience on the extent of lymph node dissection in China and worldwide,aiming to provide guidence for the extent of lymph node dissection in esophageal cancer.