Lymphadenectomy and Survival After Neoadjuvant Chemoradiation for Esophageal Adenocarcinoma: Is More Better?

• Published in: Journal of gastrointestinal surgery 2020-11, Vol.24 (11), p.2447-2455
• Main Authors: de Geus, Susanna W. L., Hirji, Sameer, Hachey, Krista J., Sachs, Teviah E., Suzuki, Kei, Ng, Sing Chau, Swanson, Scott, Litle, Virginia R., D’Amico, Thomas, Tseng, Jennifer F.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - surgery; Age; Cancer therapies; Comorbidity; Disease; Esophageal cancer; Esophageal Neoplasms - surgery; Esophagectomy; Gastroenterology; Hospitals; Humans; Lymph Node Excision; Lymphatic system; Medical prognosis; Medicine; Medicine & Public Health; Mortality; Neoadjuvant Therapy; Neoplasm Staging; Pathology; Prospective Studies; Retrospective Studies; SSAT Plenary Presentation; Surgery; Survival Rate; Variables
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-020-04750-z

Purpose The purpose of this study was to assess the impact of number of lymph nodes examined on survival in patients with esophageal adenocarcinoma who underwent neoadjuvant chemoradiation. Methods The National Cancer Database was queried for patients who underwent neoadjuvant chemoradiation followed by surgery for esophageal adenocarcinoma. Propensity scores were created predicting the odds of undergoing resection of ≥ 25 nodes. Patients were matched on propensity score. Overall survival analyses were performed using the Kaplan-Meier method. Sensitivity analyses were performed using various nodal cutoffs. Results In total, 3953 patients who underwent neoadjuvant chemoradiation were identified. The median number of resected nodes was 14 nodes (IQR, 8–20 nodes). Resection of ≥ 15 (vs.