Resection of 15 or More Nodes Improves Survival in Esophageal Cancer Treatment

Systemic lymphadenectomy with esophagectomy is recommended in clinical guidelines because it is associated with improved survival for patients with esophageal cancer. The National Comprehensive Cancer Network guidelines currently advocate for resection of ≥15 lymph nodes for patients treated with surgery alone. However, based on randomized controlled trials, neoadjuvant chemoradiotherapy or neoadjuvant chemotherapy followed by esophagectomy are the standard treatments in Western countries and Japan. Despite this, consensus is still lacking regarding whether patients who receive neoadjuvant therapy before esophagectomy would also derive benefits from systemic lymphadenectomy. Based on the literature a systemic lymphadenectomy is recommended for esophageal cancer patients as part of resection after induction therapy.