Almhanna Khaldoun, Weber Jill, Shridhar Ravi, Hoffe Sarah, Strosberg Jonathan, Meredith Kenneth
Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 334612, USA.
J Gastrointest Oncol. 2016 Jun;7(3):387-94. doi: 10.21037/jgo.2015.12.02.
We examined the impact of the number of lymph nodes (LNs) removed during esophagectomy on outcomes in esophageal cancer (EC).
From a comprehensive EC database we identified patients who underwent curative resection from 1994 to 2011. The impact of total LNs retrieved on disease-free survival (DFS) and overall survival (OS) was investigated.
In total, 635 patients were identified. Patients were divided on the basis of total number of LNs removed (<8, 9-12, 13-20, and >20). The 5-year OS and DFS rates for the group by LN category were (43%, 42%, 55%, and 36%, P=0.1836) and (44%, 37%, 46%, and 36%, P=0.5166), respectively. Total number of LNs assessed did not correlate with reduced risk of recurrence or improved survival. On multivariate analysis controlling for age, sex, histology, neoadjuvant therapy, only removal of 13-20 LN's correlated to improved oncologic outcomes.
In a tertiary cancer center, we demonstrated that only removal of 13-20 LNs during esophagectomy correlated to improved survival. While the importance of standardized pathologic examination and adequate nodal staging is of utmost importance for patients with EC undergoing esophagectomy the optimum number of LNs removed clearly warrants further investigation.
我们研究了食管癌（EC）手术中切除的淋巴结数量对预后的影响。
从一个全面的EC数据库中，我们确定了1994年至2011年接受根治性切除的患者。研究了获取的总淋巴结数量对无病生存期（DFS）和总生存期（OS）的影响。
总共确定了635例患者。根据切除的淋巴结总数（<8、9 - 12、13 - 20和>20）对患者进行分组。按淋巴结类别分组的5年总生存率和无病生存率分别为（43%、42%、55%和36%，P = 0.1836）和（44%、37%、46%和36%，P = 0.5166）。评估的淋巴结总数与降低复发风险或改善生存率无关。在对年龄、性别、组织学、新辅助治疗进行多因素分析时，仅切除13 - 20枚淋巴结与改善肿瘤学结局相关。
在一家三级癌症中心，我们证明食管癌手术中仅切除13 - 20枚淋巴结与生存率提高相关。虽然标准化病理检查和充分的淋巴结分期对接受食管癌手术的患者至关重要，但切除的最佳淋巴结数量显然值得进一步研究。
