Lymphadenectomy extent is closely related to long-term survival in esophageal cancer☆

Kang, Chang Hyun; Kim, Young Tae; Jeon, Sang-Hoon; Sung, Sook-Whan; Kim, Joo Hyun

doi:10.1016/j.ejcts.2006.10.033

Cited by 61 publications

(37 citation statements)

References 24 publications

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“…Overall survival at 5 years was 21.2% versus 36.3% versus 53.7% for patients resected with a one-, two-, or three-field lymphadenectomy (P ¼ 0.019). However the benefit of more extensive lymphadenectomy was predominantly in the N0 group [12]. This suggests that the benefit is predominantly related to stage migration.…”

Section: Relationship Between Extent Of Surgical Resection and Prognosismentioning

confidence: 72%

“…Similarly, Kang [12] also found increased lymph node involvement with increased number of nodes dissected. Nodal metastases were found in 53% of patients having a three-field dissection with a median of 33 nodes resected, whereas nodal metastases were found in 33% of patients having a one-field dissection with a median of 17 nodes resected.…”

Section: Extent Of Lymphadenectomy and Accuracy Of Stagingmentioning

confidence: 85%

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The role of lymphadenectomy in esophageal cancer

Darling

2008

Journal of Surgical Oncology

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Lymph node metastases are common in esophageal cancer and are associated with a poor prognosis. Resection and examination of 15-18 lymph nodes is required for adequate staging of esophageal cancer. Improved survival is associated with involvement of five or fewer nodes or lymph node ratio (LNR) of < 0.10-0.20. More extensive lymph node dissection during esophagectomy offers improved staging but may also provide therapeutic benefit in terms of control of locoregional disease and possibly improved overall survival.

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Section: Relationship Between Extent Of Surgical Resection and Prognosismentioning

confidence: 72%

Section: Extent Of Lymphadenectomy and Accuracy Of Stagingmentioning

confidence: 85%

The role of lymphadenectomy in esophageal cancer

Darling

2008

Journal of Surgical Oncology

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“…[19][20][21][22] The extent of lymph node dissection, whether by MIE or open techniques, has not been addressed in any randomised controlled trials or meta-analyses. There is scanty evidence to indicate if MIE can reproduce similar standards of tumour and lymph node clearance and perhaps 25).…”

Section: Discussionmentioning

confidence: 98%

Does Minimally Invasive Esophagectomy (MIE) Provide for Comparable Oncologic Outcomes to Open Techniques? A Systematic Review

Dantoc

Cox

Eslick

2012

Journal of Gastrointestinal Surgery

119

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“…Many previous studies demonstrated that the number of lymph nodes removed is an independent predictor of survival after esophagectomy for cancer (4,(23)(24)(25)(26)(27). The extent of lymph node dissection in esophageal cancer surgery was estimated by the number of resected regional lymph nodes.…”

Section: Efficacy Of Ln Dissection According To Tumor Locationmentioning

confidence: 99%

Pattern of lymph node metastases of squamous cell esophageal cancer based on the anatomical lymphatic drainage system: efficacy of lymph node dissection according to tumor location

Tachimori

2017

J. Thorac. Dis.

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Knowing the anatomical lymphatic drainage of the esophagus is crucial to understanding the dissemination pattern of esophageal tumor. During the embryonal growth, the middle and lower part of the esophagus stretches as the lymphatic networks develop in the submucosal layer. The abundant submucosal lymphatics drain in a longitudinal fashion directly to their proximal and distal ends. The lymphatic route from the proximal esophagus through recurrent nerve nodes to supraclavicular nodes are a component of the mesentery of the proximal esophagus. The lower esophagus mostly drains its lymph into paracardial nodes related to celiac nodes through the mesentery of the distal esophagus. Lymphatic routes to mid and lower paraesophageal nodes usually originate from the intermuscular area of the muscularis propria. The lymphatic communication between the submucosa and intermuscular area is limited. The anatomical concept was confirmed clinically by a large series of single institution and the nationwide registry in Japan. The clinical data for the incidence of involved nodes verified the anatomical observations that long longitudinal extension of lymphatic drainage in the submucosa connected to the upper mediastinum lymphatics and paracardial lymphatics. The extent of dissection should be not tailored according to the anatomical distance from the tumor but according to the incidences of metastasis of each area, those were differed by tumor location. The areas for node dissection should be modified according to the tumor location. Although in patients with tumor limited to within the submucosal layer, even with tumors located in the mid-and lower esophagus, lymphatic metastasis was frequent in the upper mediastinum and perigastric area via the abundant submucosal lymphatics in a longitudinal fashion. When tumor invades or penetrates the muscle layer, the incidence of paraesophageal lymph node metastasis in the middle and lower mediastinum increases.

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Lymphadenectomy extent is closely related to long-term survival in esophageal cancer☆

Abstract: A wider extent of lymphadenectomy in esophageal cancer was associated with better long-term survival than limited lymphadenectomy, especially in N0 patients. In addition, increased survival was found to be inversely associated with locoregional recurrence.

Cited by 61 publications

References 24 publications

The role of lymphadenectomy in esophageal cancer

The role of lymphadenectomy in esophageal cancer

Does Minimally Invasive Esophagectomy (MIE) Provide for Comparable Oncologic Outcomes to Open Techniques? A Systematic Review

Pattern of lymph node metastases of squamous cell esophageal cancer based on the anatomical lymphatic drainage system: efficacy of lymph node dissection according to tumor location

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