Nusrath Syed, Saxena Ajesh Raj, Raju K V V N, Patnaik Sujith, Subramanyeshwar Rao T, Bollineni Naren
Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India.
Indian J Surg Oncol. 2020 Sep;11(3):538-548. doi: 10.1007/s13193-020-01156-w. Epub 2020 Aug 3.
Lymph nodal metastasis is one of the most important prognostic factors determining survival in patients with carcinoma esophagus. Radical esophagectomy, with the resection of surrounding lymph nodes, is considered the prime treatment of carcinoma esophagus. An extensive lymphadenectomy improves the accuracy of staging and betters locoregional control, but its effect on survival is still not apparent and carries the disadvantage of increased morbidity. The extent of lymphadenectomy during esophagectomy also remains debatable, with many studies revealing contradictory results, especially in the era of neoadjuvant therapy The pattern of distribution and the number of nodal metastasis are modified by neoadjuvant therapy. The paper reviews the existing evidence to determine whether increased lymph node yield improves oncological outcomes in patients undergoing esophagectomy with particular attention to those patients receiving neoadjuvant therapy.
淋巴结转移是决定食管癌患者生存的最重要预后因素之一。根治性食管切除术，连同周围淋巴结的切除，被认为是食管癌的主要治疗方法。广泛的淋巴结清扫可提高分期的准确性并改善局部区域控制，但其对生存的影响仍不明显，且具有发病率增加的缺点。食管切除术中淋巴结清扫的范围仍存在争议，许多研究结果相互矛盾，尤其是在新辅助治疗时代。新辅助治疗会改变淋巴结转移的分布模式和数量。本文回顾现有证据，以确定增加淋巴结清扫数量是否能改善接受食管切除术患者的肿瘤学结局，尤其关注那些接受新辅助治疗的患者。
