Three-field lymphadenectomy for esophageal cancer.

Esophagectomy with three-field lymph node dissection can be performed with a mortality and morbidity similar to that of less extensive operations. Approximately one third of patients will have previously unsuspected metastasis to the recurrent laryngeal nodes. This pattern of spread seems to be independent of cell type or tumor location. The impact of the procedure on patient survival is unclear; however, our early results are encouraging.