The role of lymphadenectomy in esophageal cancer.
OBJECTIVE
To address the role of lymphadenectomy in the treatment of esophageal cancer.


BACKGROUND
The role of lymphadenectomy in esophageal cancer surgery is controversial, and there is a lack of uniformity as to what the term means.


METHODS
The published data was reviewed to evaluate the evidence base for, and the terminology associated with, lymphadenectomy for esophageal cancer.


RESULTS
Recommendations are given for a standardization of terminology for radical and nonradical lymphadenectomy procedures. Although there is no doubt that the presence of lymph node metastases worsens prognosis for a patient, there is a lack of high-level evidence to support lymphadenectomy. Logically, the best procedure, from a staging and perhaps theoretical oncologic point of view, is a 3-field lymphadenectomy but it is not clear which patients, if any, are most likely to benefit.


CONCLUSIONS
Well-designed randomized controlled trials are required to test, in a scientific manner, which of these procedures we should be offering our patients.
Jamieson
Glyn G
GG
Discipline of Surgery, Royal Adelaide Hospital, University of Adelaide, Adelaide, Australia. glyn.jamieson@adelaide.edu.au
Lamb
Peter J
PJ
Thompson
Sarah K
SK
D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D018579:Patient Selection; D009626:Terminology as Topic