BACKGROUND: We examined the impact of the number of lymph nodes (LNs) removed during esophagectomy on outcomes in esophageal cancer (EC). METHODS: From a comprehensive EC database we identified patients who underwent curative resection from 1994 to 2011. The impact of total LNs retrieved on disease-free survival (DFS) and overall survival (OS) was investigated. RESULTS: In total, 635 patients were identified. Patients were divided on the basis of total number of LNs removed (<8, 9-12, 13-20, and >20). The 5-year OS and DFS rates for the group by LN category were (43%, 42%, 55%, and 36%, P=0.1836) and (44%, 37%, 46%, and 36%, P=0.5166), respectively. Total number of LNs assessed did not correlate with reduced risk of recurrence or improved survival. On multivariate analysis controlling for age, sex, histology, neoadjuvant therapy, only removal of 13-20 LN's correlated to improved oncologic outcomes. CONCLUSIONS: In a tertiary cancer center, we demonstrated that only removal of 13-20 LNs during esophagectomy correlated to improved survival. While the importance of standardized pathologic examination and adequate nodal staging is of utmost importance for patients with EC undergoing esophagectomy the optimum number of LNs removed clearly warrants further investigation.
BACKGROUND: We examined the impact of the number of lymph nodes (LNs) removed during esophagectomy on outcomes in esophageal cancer (EC). METHODS: From a comprehensive EC database we identified patients who underwent curative resection from 1994 to 2011. The impact of total LNs retrieved on disease-free survival (DFS) and overall survival (OS) was investigated. RESULTS: In total, 635 patients were identified. Patients were divided on the basis of total number of LNs removed (<8, 9-12, 13-20, and >20). The 5-year OS and DFS rates for the group by LN category were (43%, 42%, 55%, and 36%, P=0.1836) and (44%, 37%, 46%, and 36%, P=0.5166), respectively. Total number of LNs assessed did not correlate with reduced risk of recurrence or improved survival. On multivariate analysis controlling for age, sex, histology, neoadjuvant therapy, only removal of 13-20 LN's correlated to improved oncologic outcomes. CONCLUSIONS: In a tertiary cancer center, we demonstrated that only removal of 13-20 LNs during esophagectomy correlated to improved survival. While the importance of standardized pathologic examination and adequate nodal staging is of utmost importance for patients with EC undergoing esophagectomy the optimum number of LNs removed clearly warrants further investigation.
Authors: Jan B F Hulscher; Johanna W van Sandick; Angela G E M de Boer; Bas P L Wijnhoven; Jan G P Tijssen; Paul Fockens; Peep F M Stalmeier; Fiebo J W ten Kate; Herman van Dekken; Huug Obertop; Hugo W Tilanus; J Jan B van Lanschot Journal: N Engl J Med Date: 2002-11-21 Impact factor: 91.245
Authors: Alexander J Greenstein; Virginia R Litle; Scott J Swanson; Celia M Divino; Stuart Packer; Juan P Wisnivesky Journal: Cancer Date: 2008-03-15 Impact factor: 6.860
Authors: Nabil P Rizk; Hemant Ishwaran; Thomas W Rice; Long-Qi Chen; Paul H Schipper; Kenneth A Kesler; Simon Law; Toni E M R Lerut; Carolyn E Reed; Jarmo A Salo; Walter J Scott; Wayne L Hofstetter; Thomas J Watson; Mark S Allen; Valerie W Rusch; Eugene H Blackstone Journal: Ann Surg Date: 2010-01 Impact factor: 12.969
Authors: Flávio Roberto Takeda; Francisco Tustumi; Bruna de Camargo Nigro; Rubens Antonio Aissar Sallum; Ulysses Ribeiro-Junior; Ivan Cecconello Journal: Arq Bras Cir Dig Date: 2019-12-20