title: Lymph Node Harvest During Esophagectomy Is Not Influenced by Use of Neoadjuvant Therapy or Clinical Disease Stage.
abstract: BACKGROUND
  The purpose of this study was to evaluate the effects of neoadjuvant therapy on lymph node harvest (LNH), lymph node ratio (LNR), and overall survival rates after esophagectomy.
  
  
  METHODS
  A retrospective analysis of 111 patients who underwent esophagectomy for esophageal adenocarcinoma from 2001 to 2010 was performed. Patients were divided into two groups: neoadjuvant chemoradiotherapy prior to surgery (NEOSURG) versus surgery alone (SURG).
  
  
  RESULTS
  There were 83 patients (75%) in the NEOSURG group and 28 (25%) in the SURG group with a mean age of 66 and 67 years, respectively. The median LNH in the NEOSURG group and SURG group was 16.0 and 15.5, respectively (p = 0.57). Within the NEOSURG group, the median LNH was 16 for complete responders, 14 for partial responders, 16 for nonresponders, and 18 in those who were pathologically upstaged (p = 0.434). The median LNR was 0, 0, 0.1, and 0.2, respectively (p < 0.001). Complete response after neoadjuvant therapy demonstrated a trend toward improved survival (p = 0.056).
  
  
  CONCLUSIONS
  The LNH was not significantly influenced by neoadjuvant treatment or pathologic response. The LNR was inversely related to pathologic response after neoadjuvant therapy. Complete pathologic response to neoadjuvant therapy trends to improve survival rates.
authors.affiliation: Department of Surgery, the Digestive Health Center and the Knight Cancer Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mail code L223A, Portland, OR, 97239, USA.
authors.forename: Renato A
authors.initials: RA
authors.lastname: Luna
authors.forename: James P
authors.initials: JP
authors.lastname: Dolan
authors.forename: Brian S
authors.initials: BS
authors.lastname: Diggs
authors.forename: Nathan W
authors.initials: NW
authors.lastname: Bronson
authors.forename: Brett C
authors.initials: BC
authors.lastname: Sheppard
authors.forename: Paul H
authors.initials: PH
authors.lastname: Schipper
authors.forename: Brandon H
authors.initials: BH
authors.lastname: Tieu
authors.forename: Benjamin T
authors.initials: BT
authors.lastname: Feeney
authors.forename: Ken M
authors.initials: KM
authors.lastname: Gatter
authors.forename: Gina M
authors.initials: GM
authors.lastname: Vaccaro
authors.forename: Charles R
authors.initials: CR
authors.lastname: Thomas
authors.forename: John G
authors.initials: JG
authors.lastname: Hunter
mesh_terms: D000230:Adenocarcinoma; D000368:Aged; D059186:Chemoradiotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000628:therapy*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome