Lymph Node Harvest During Esophagectomy Is Not Influenced by Use of Neoadjuvant Therapy or Clinical Disease Stage

Introduction The purpose of this study was to evaluate the effects of neoadjuvant therapy on lymph node harvest (LNH), lymph node ratio (LNR), and overall survival rates after esophagectomy. Methods A retrospective analysis of 111 patients who underwent esophagectomy for esophageal adenocarcinoma from 2001 to 2010 was performed. Patients were divided into two groups: neoadjuvant chemoradiotherapy prior to surgery (NEOSURG) versus surgery alone (SURG). Results There were 83 patients (75 %) in the NEOSURG group and 28 (25 %) in the SURG group with a mean age of 66 and 67 years, respectively. The median LNH in the NEOSURG group and SURG group was 16.0 and 15.5, respectively (p=0.57). Within the NEOSURG group, the median LNH was 16 for complete responders, 14 for partial responders, 16 for nonresponders, and 18 in those who were pathologically upstaged (p=0.434). The median LNR was 0, 0, 0.1, and 0.2, respectively (p<0.001). Complete response after neoadjuvant therapy demonstrated a trend toward improved survival (p=0.056). Conclusion TheLNH wasnot significantlyinfluencedbyneoadjuvant treatment orpathologicresponse. The LNRwas inversely related to pathologicresponseafter neoadjuvant therapy.Completepathologicresponsetoneoadjuvant therapy trendstoimprove survival rates.