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Back to 2015 Annual Meeting Program the Requirement of Lymphadenectomy for Esophageal Carcinoma: Harvesting Least Lymph Node Stations Is More Applicable Long-QI Chen*, Jun Peng, Yu-Shang Yang Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
Objective: The new AJCC TNM system for esophageal cancer recommends at least 12 regional lymph nodes (LN) should be harvested in order to have an accurate N-staging and radical dissection. However, the counting of LN might be difficult or inaccurate due to the calcification, inflammation or fusion of LN themselves. The aim of this study was to investigate if using least LN stations to optimize the lymphadenectomy requirement. Methods: The clinicopathological data on patients with esophageal cancer admitted between 2007 through 2013 was reviewed. Patients with radical-intent esophagectomy with at least 12 regional lymph nodes resected were included for the analysis. The heterogeneity in numbers for lymph nodes sampling, as well as the optimal station number for lymphadenectomy were investigated. Results: Totally 1328 patients were included, with a follow-up rate of 94%, and overall 5-year survival rate of 39%. The number of LN resection ranged between 12 and 62, with a median of 19. The LN number varied mostly in the following stations: Gruop 1 (1-26), Group 2 (1-22), Group 4 (1-18), Group 7 (1-29), Group 8 (1-18) and Group 17 (1-24). Log-rank analysis demonstrated that the cut-point for LN stations number between <7 and >=7 revealing a most significant survival difference (36.2% vs. 47.4%；X2=8.823，P=0.003)(Table 1). Conclusion: The requirement of removal at least 7 LN stations is better than least 12 lymph nodes themselves for a radical lymphadenectomy and an accurate N staging for esophageal carcinoma.
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