Influence of lymph node dissection on survival in esophageal cancer

✍ Scribed by Swisher, Stephen G.; Putnam, Joe B.

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 18 KB
• Volume: 69
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/(sici)1096-9098(199810)69:2<117::aid-jso14>3.0.co;2-n

✦ Synopsis

It is important not to overinterpret the good survival outcomes reported by Kawahara et al. [1] for three-vs. two-field lymphadenectomy in esophageal cancer. They performed a retrospective review and found that patients who had less than four positive nodes had prolonged survival following three-field lymphadenectomy in comparison with two-field lymphadenectomy. These data must be viewed cautiously since the increased extent of lymphadenectomy may simply have increased the number of lymph nodes sampled and hence the number of positive lymph nodes found. Thus, similar patients would be staged differently simply because of the surgical procedure and extent of lymphadenectomy. The improved survival would therefore be due to improved staging rather than any true benefit of surgery. A randomized trial with careful preoperative staging would be the only way to try to determine whether increased lymph node dissection has any therapeutic benefit.