title: Prognostic implications of lymphadenectomy in esophageal cancer after neo-adjuvant therapy: a single center experience.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Creighton University Medical Center, Omaha, NE 68131, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Torgersen
authors.forename: Abhishek
authors.initials: A
authors.lastname: Sundaram
authors.forename: Masato
authors.initials: M
authors.lastname: Hoshino
authors.forename: Brittany
authors.initials: B
authors.lastname: Willer
authors.forename: Xiang
authors.initials: X
authors.lastname: Fang
authors.forename: Tsewang
authors.initials: T
authors.lastname: Tashi
authors.forename: Tommy
authors.initials: T
authors.lastname: Lee
authors.forename: Sumeet K
authors.initials: SK
authors.lastname: Mittal
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D012189:Retrospective Studies; D015996:Survival Rate