ArticleAnnals of surgical oncology2020
Adequate Lymphadenectomy as a Quality Measure in Esophageal Cancer: Is there an Association with Treatment Approach?
Article in Annals of surgical oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Impact of Centralizing Esophageal Cancer Surgery at High-Volume Centers on Long-Term Survival: Individual Patient Data Meta-Analysis.Annals of surgical oncology · 2025Pooled it
- The use of indocyanine green and near-infrared fluorescence in the detection of metastatic lymph nodes during oesophageal and gastric cancer resection: a systematic review and meta-analysis.Surgical endoscopy · 2025Pooled it
- Is Robotic Surgery the Future for Resectable Esophageal Cancer?: A Systematic Literature Review of Oncological and Clinical Outcomes.Annals of surgical oncology · 2024Pooled it
- Quality Performance Indicators for the Surgical Management of Oesophageal Cancer: A Systematic Literature Review.World journal of surgery · 2023Pooled it
- Does robotic-assisted esophagectomy improve outcomes compared to other techniques? An NCDB analysis of access and disparities.Surgical endoscopy · 2026Article
- CT-based multiple instance and ensemble learning for lymph node metastasis prediction in esophageal squamous cell carcinoma: a multicentre, retrospective study.Cancer imaging : the official publication of the International Cancer Imaging Society · 2026Article
- Sentinel Lymph Node Mapping in Esophageal Cancer: Many Routes to an Elusive Destination.Annals of surgical oncology · 2026Article
- Number of Examined Lymph Nodes in the Highest Quartile Enhances Staging and Prognosis for Patients with Esophageal Cancer Receiving Neoadjuvant Therapy.Annals of surgical oncology · 2026Article
- Sentinel Lymph Node Mapping in Esophageal Cancer: Current Status and Future Directions.Annals of surgical oncology · 2025Review
- A novel technique for lymphadenectomy along the left recurrent laryngeal nerve during minimally invasive esophagectomy: a retrospective cohort study.BMC surgery · 2023Article
- Article
- Optimal Range of Lymphadenectomy in Pathological Stage T1 and T2 Esophageal Squamous Cell Carcinoma.Frontiers in oncology · 2021Article
- ASO Author Reflections: Achieving Adequate Lymphadenectomy in Esophageal Cancer Resection.Annals of surgical oncology · 2020Article
- Adherence to quality measures improves survival in esophageal cancer in a retrospective cohort study of the national cancer database from 2004 to 2016.Journal of thoracic disease · 2020Article
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5 authors.
Funding
Abstract
backgroundThe national comprehensive cancer network defines adequate lymphadenectomy as evaluation of ≥ 15 lymph nodes in esophageal cancer. However, varying thresholds have been suggested following neoadjuvant therapy.
objectivesOur objectives were to (1) explore trends in adequate lymphadenectomy rates over time; (2) evaluate unadjusted lymphadenectomy yield by treatment characteristics; and (3) identify independent factors associated with adequate lymphadenectomy.
methodsThe National Cancer Data Base was used to identify patients who underwent esophagectomy for cancer from 2004 to 2015. Adequate lymphadenectomy trends over time were evaluated using the Cochrane-Armitage test, and lymph node yield by treatment approach was compared using the Mann-Whitney U and Kruskal-Wallis tests. Associations with treatment factors were assessed by multivariable logistic regression.
resultsAmong 24,413 patients, 9919 (40.6%) had adequate lymphadenectomy. Meeting the nodal threshold increased over time (52.6% in 2015 vs. 26.0% in 2004; p < 0.01). Lymph node yield did not differ based on neoadjuvant therapy (median 12 [interquartile range 7-19] with and without neoadjuvant therapy; p = 0.44). Adequate lymphadenectomy was not associated with neoadjuvant therapy (40.5% vs. 40.8%, odds ratio [OR] 0.94, 95% confidence interval [CI] 0.82-1.07), but was associated with surgical approach (52.7% of laparoscopic cases, OR 1.28, 95% CI 1.06-1.56; 61.2% of robotic cases, OR 1.71, 95% CI 1.34-2.19, vs. 43.5% of open cases), and increasing annual esophagectomy volume (55.6% in the fourth quartile vs. 32.6% in the first quartile; OR 3.57, 95% CI 2.35-5.43).
conclusionsDespite increases over time, only 50% of patients undergo adequate lymphadenectomy during esophageal cancer resection. Adequate lymphadenectomy was not associated with neoadjuvant therapy. Focusing on surgical approach and esophagectomy volume may further improve adequate lymphadenectomy rates.
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