Scope of Lymphadenectomy Not Tied to Esophageal CA Survival
(HealthDay News) — For patients undergoing esophageal cancer surgery, the extent of lymphadenectomy seems not to influence all-cause or disease-specific survival, according to a study published online Sept. 2 in JAMA Surgery.
Jesper Lagergren, MD, PhD, from the Guy's and St. Thomas' NHS Foundation Trust in London, and colleagues examined data from a cohort of patients who underwent esophagectomy for cancer in 2000–2012 at a high-volume hospital, with follow-up until 2014.
The researchers found that 83.5% of the 606 included patients had adenocarcinoma of the esophagus. Fifty-three percent of participants died within five years of surgery and 39% died of tumor recurrence. There was no significant association between the extent of lymphadenectomy and all-cause or disease-specific mortality, irrespective of the categorization of lymphadenectomy or stratification for T category, calendar period, or chemotherapy. There was no significant reduction in all-cause five-year mortality for patients in the fourth vs. the lowest quartile of the number of removed nodes (21 to 52 vs. 0 to 10 nodes; hazard ratio, 0.86; 95% confidence interval, 0.63–1.17), particularly not in the most recent calendar period (hazard ratio, 0.98; 95% confidence interval, 0.57–1.66) for years 2007–2012.
"This study indicated that the extent of lymphadenectomy during surgery for esophageal cancer might not influence five-year all-cause or disease-specific survival," the authors write. "These results challenge current clinical guidelines."