SUMMARY. Common hepatic artery lymph node dissection is regarded as a standard procedure in esophageal
cancer surgery because of aggressive lymphatic dissemination of esophageal cancer. However, lymph node dissection
can prolong operation time and may be associated with complications such as chylous ascites. Here, we aimed
to evaluate the effectiveness of common hepatic artery lymph node dissection in clinical T1N0 thoracic esophageal
squamous cell carcinoma. Between 1996 and 2009, 1390 patients underwent surgery for esophageal cancer in our
institution, and 209 were found to have clinical T1N0 disease. Exclusion criteria were nonsquamous carcinoma,
double primary cancer, definite distant metastasis, administration of neoadjuvant treatment, and incomplete
abdominal lymph node dissection. We retrospectively analyzed medical records, operative and pathologic data, and
follow-up information. Forty-two patients were excluded from the study. Among the 167 enrolled patients,
preoperative endoscopic ultrasound evaluation was performed in 160 patients. Fifty-two patients had distal esophageal
or esophagogastric junction tumor. Surgery included 2 cases of tri-incisional esophagectomy, 17 cases of
transhiatal esophagectomy, and 148 cases of two-field esophagectomy (Ivor Lewis operation). Common hepatic
artery lymph node dissection was performed in all cases, and none of the patients had metastasis. Mean follow-up
period was 35.4  28.7 months. In-hospital mortality was one, and 5-year survival rate was 80.6%. Among the 15
patients with recurrence, there were two distant metastases and five distant and local recurrences but no intraabdominal
recurrence with common hepatic artery lymph node. Common hepatic artery lymph node dissection
may be safely omitted in surgery for clinical T1N0 esophageal squamous cell carcinoma when preoperative
evaluations including chest computed tomography, positron emission tomography and computed tomography,
and esophagogastroduodenoscopy or endoscopic ultrasound are performed.