Prognostic Implications of Lymphadenectomy in Esophageal Cancer After Neo-adjuvant Therapy: A Single Center Experience

Introduction: 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. Conclusion: 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.