Decoding the Prognostic Significance of Lymphadenectomy Extent in Esophageal Cancer: A Navigational Study

Lymphadenectomy Extent in Esophageal Cancer

Abstract

Objective: Esophageal cancer lacks a standard surgical approach, and opinions differ on lymphadenectomy extent. This study aims to assess the correlation between the extent of lymphadenectomy, patient and tumor characteristics, and the survival of esophageal cancer.

Methods: Data of 101 patients who underwent surgery for esophageal cancer between 1990 and 2022 were analyzed retrospectively. Mean survival and 1-, 3-, 5-, and 10-year overall survival rates were examined. Overall survival rates were separately evaluated for adenocarcinoma and squamous cell carcinoma. The relationship between gender, age, tumor size, stage, total number of harvested lymph nodes, and survival was analyzed.

Results: Among 101 patients, 34 (33.7%) were female, and 67 (66.3%) were male, with a mean age of 61.01 ± 12.01 years. Of these patients, 82 (81.2%) had squamous cell carcinoma, while 16 (15.8%) had adenocarcinoma. The mean follow-up was 61.2 months, and the overall survival averaged 59.2 ± 42.12 months. Only the total harvested lymph node count showed a statistically significant impact on survival (p=0.17).

Conclusion: There is a clear association between the total number of harvested lymph nodes and overall survival. In squamous cell cancers, extent lymph node dissection improves long-term survival. However, the routine use of extended lymphadenectomy in distally located cancers remains a subject of debate.