The impact of lymphadenectomy on lymph node recurrence after performing various treatments for esophageal squamous cell carcinoma

Abstract

BackgroundTreatment for regional lymph node recurrence after initial treatment for esophageal squamous cell carcinoma (ESCC) differs among institutions. Though some retrospective cohort studies have shown that lymphadenectomy for cervical lymph node recurrence is safe and leads to long-term survival, the efficacy remains unclear. In this study, we investigated the long-term outcomes of patients who underwent lymphadenectomy for regional recurrence after treatment for ESCC.Patients and methodsWe retrieved 20 cases in which lymphadenectomy was performed for lymph node recurrence after initial treatment for ESCC in our hospital from January 2003 to December 2016. Initial treatments included esophagectomy, endoscopic resection (ER) and chemoradiotherapy/chemotherapy (CRT/CT). Overall survival (OS) and recurrence-free survival (RFS) after lymphadenectomy were calculated by the Kaplan-Meier method. We also used a univariate analysis with a Cox proportional hazards model to determine factors influencing the long-term outcomes.ResultsThe 5-year OS and RFS of patients who underwent secondary lymphadenectomy for recurrence after initial treatment were 55.0% and 35.3%, respectively. The 5-year overall survival rates of patients who received esophagectomy, ER and CRT/CT as initial treatments, were 45.5%, 80.0% and 50.0%, respectively. The 5-year OS rates of patients with pStage I and pStage II-IVB lymph node recurrence were 75.0% and 41.7%, respectively.ConclusionsLymphadenectomy for regional recurrence after initial treatment for ESCC is effective to some degree. Patients with regional recurrence after initial treatment for Stage I ESCC have a good prognosis; thus, lymphadenectomy should be considered for these cases.