ObjectiveTo evaluate the impact of three-field versus two-field lymph node dissection on postoperative complications and survival outcomes in patients with clinically unresectable esophageal squamous cell carcinoma undergoing conversion surgery. MethodsPatients with esophageal squamous cell carcinoma who underwent conversion surgery at Sichuan Cancer Hospital between January 2018 and March 2020 were retrospectively included. Based on the extent of lymph node dissection, patients were divided into a three-field group and a two-field group. Postoperative complications, overall survival (OS), and disease-free survival (DFS) were compared between the two groups. Cox regression and Kaplan-Meier analysis were used to identify prognostic factors. ResultsA total of 58 patients were included, consisting of 51 males and 7 females, with a median age of 61.50 (53.25, 65.00) years. The three-field group comprised 17 patients, and the two-field group comprised 41 patients. The results showed that three-field lymph node dissection did not increase the risk of complications. The OS and DFS in the three-field group tended to be better than those in the two-field group, but the differences were not statistically significant (P=0.228, P=0.342). Cox regression analysis indicated that OS and DFS were not significantly correlated with the extent of lymph node dissection (P=0.234, P=0.347) but were associated with R0 resection status (P=0.027, P=0.069). ConclusionThree-field lymph node dissection demonstrates good safety and may provide survival benefits in specific patient subgroups. R0 resection is a key factor influencing surgical prognosis.
