ArticleBMJ surgery, interventions, & health technologies2020
Extent and consequences of lymphadenectomy in oesophageal cancer surgery: case vignette survey.
Article in BMJ surgery, interventions, & health technologies, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Perioperative outcomes and survival of indocyanine green-guided minimally esophagectomy in patients with esophageal cancer: a retrospective comparison study.Quantitative imaging in medicine and surgery · 2026Article
- Towards early and broad evaluation of innovative surgical devices: integrating evidence synthesis, stakeholder involvement, and health economic modeling into the clinical research stages of the IDEAL framework.BMJ surgery, interventions, & health technologies · 2022Review
- Identifying Biomarkers in Lymph Node Metastases of Esophageal Adenocarcinoma for Tumor-Targeted Imaging.Molecular diagnosis & therapy · 2020Article
- Selecting esophageal cancer patients for lymphadenectomy after neoadjuvant chemoradiotherapy: a modeling study.BMJ surgery, interventions, & health technologies · 2020Article
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Authors and funding
7 authors.
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Abstract
objectivesLymph node dissection (LND) is part of the standard operating procedure in patients with resectable oesophageal cancer after neoadjuvant chemoradiotherapy regardless of lymph node (LN) status. The aims of this case vignette survey were to acquire expert opinions on the current practice of LND and to determine potential consequences of non-invasive LN staging on the extent of LND and postoperative morbidity.
designAn online survey including five short clinical cases (case vignettes) was sent to 272 oesophageal surgeons worldwide.
participants86 oesophageal surgeons (median experience in oesophageal surgery of 15 years) participated in the survey (response rate 32%).
main outcome measuresExtent of standard LND, potential changes in LND based on accurate LN staging and consequences for postoperative morbidity were evaluated.
resultsStandard LND varied considerably between experts; for example, pulmonary ligament, splenic artery, aortopulmonary window and paratracheal LNs are routinely dissected in less than 60%. The omission of (parts of) LND is expected to decrease the number of chyle leakages, pneumonias, and laryngeal nerve pareses and to reduce operating time. In order to guide surgical treatment decisions, a diagnostic test for LN staging after neoadjuvant therapy requires a minimum sensitivity of 92% and a specificity of 90%.
conclusionsThis expert case vignette survey study shows that there is no consensus on the extent of standard LND. Oesophageal surgeons seem more willing to extend LND rather than omit LND, based on accurate LN staging. The majority of surgeons expect that less extensive LND can reduce postoperative morbidity.
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