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Prognostic Implications of Lymphadenectomy in Esophageal Cancer After Neo-adjuvant Therapy: a Single Center Experience

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

The objective of this study is to explore the prognostic implications of lymphadenectomy in esophageal cancer patients after neo-adjuvant therapy.

Methods

Retrospective review of a prospectively maintained database identified esophageal cancer patients with locoregional disease who received neo-adjuvant therapy and surgery. Patients were grouped based on the number of nodes resected, pathological lymph node status, and percentage of positive nodes. Kaplan–Meier curves were used to analyze overall survival (OS) and disease-free survival (DFS). Log-rank test was used to compare survival between groups.

Results

Eighty-four patients formed the study group. Patients with ≥18 nodes resected had a significantly longer median OS than those with <18 nodes resected (68.6 vs. 29.6 months; p = 0.014). Lymph node-negative patients had significantly longer median OS (51.4 vs. 27.4 months; p = 0.025) and DFS (45.3 vs. 12.9 months; p = 0.03) when compared to lymph node-positive patients. Patients with a percentage of positive nodes <0.25 had a significantly longer median OS (31.1 vs. 17.8 months; p = 0.015) and DFS (21.7 vs. 8.9 months; p = 0.021) than patients with ≥0.25% positive.

Conclusion

Extent of lymphadenectomy, percentage of positive nodes, and pathological lymph node status are significant prognostic markers in patients who undergo esophagectomy after neo-adjuvant therapy.

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Authors and Affiliations

  1. Department of Surgery, Creighton University Medical Center, 601 N 30th St, Suite 3700, Omaha, NE, 68131, USA

    Zachary Torgersen, Abhishek Sundaram, Masato Hoshino, Brittany Willer, Tommy Lee & Sumeet K. Mittal

  2. Biostatistical Core, Office of Research and Compliance Services, Creighton University, Omaha, NE, 68178, USA

    Xiang Fang

  3. Department of Medicine, Creighton University Medical Center, 601 N 30th St, Suite 5850, Omaha, NE, 68178, USA

    Tsewang Tashi

Authors
  1. Zachary Torgersen
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  2. Abhishek Sundaram
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  3. Masato Hoshino
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  4. Brittany Willer
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  5. Xiang Fang
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  6. Tsewang Tashi
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  7. Tommy Lee
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  8. Sumeet K. Mittal
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Correspondence to Sumeet K. Mittal.

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Torgersen, Z., Sundaram, A., Hoshino, M. et al. Prognostic Implications of Lymphadenectomy in Esophageal Cancer After Neo-adjuvant Therapy: a Single Center Experience. J Gastrointest Surg 15, 1769–1776 (2011). https://doi.org/10.1007/s11605-011-1635-2

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  • DOI: https://doi.org/10.1007/s11605-011-1635-2

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