title: Therapeutic value of lymph node dissection for esophageal squamous cell carcinoma after neoadjuvant chemotherapy.
abstract: OBJECTIVE
  The optimal extent of lymphadenectomy in patients with esophageal cancer is controversial. This study aimed to examine the therapeutic value of lymph node (LN) dissection for each LN station in patients with esophageal squamous cell carcinoma (ESCC) who receive neoadjuvant chemotherapy.
  
  
  METHODS
  In 304 patients with ESCC who underwent neoadjuvant chemotherapy, Efficacy Index (EI) was calculated by multiplying the incidence of metastasis by the 3-year survival rate of patients with positive nodes for each LN station.
  
  
  RESULTS
  Prognosis was better in responders to neoadjuvant chemotherapy than non-responders (3-year survival; 66.3% vs 48.1%, P = 0.0035). The total number of resected LNs did not affect survival although the number of positive LNs did. The number of resected LNs did not correlate with the number of metastatic LNs. Cardiac LN and recurrent nerve LN showed high EI, irrespective of tumor location. EI for each LN station did not vary according to the response to neoadjuvant therapy.
  
  
  CONCLUSIONS
  The present study showed that therapeutic value of each LN was not affected by preoperative chemotherapy. The location of resected LNs rather than the total number of resected LNs may be more important to maximize the survival benefit of lymphadenectomy.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.|Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyata
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamasaki
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Makino
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyazaki
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Kurokawa
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Nakajima
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Takiguchi
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D016629:Esophagectomy / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000401:mortality*; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate
keywords: efficacy index; esophageal cancer; esophagectomy; lymph node dissection; neoadjuvant chemotherapy; neoadjuvant therapy