S. Saha et Tcb. Dehn, Ratio of invaded to removed lymph nodes as a prognostic factor in adenocarcinoma of the distal esophagus and esophagogastric junction, DIS ESOPHAG, 14(1), 2001, pp. 32-36
This study examined the influence of nodal harvest and the proportion of po
sitive nodes on survival in 59 patients with adenocarcinoma of the distal e
sophagus and esophagogastric junction undergoing esophagectomy with curativ
e intent. A total of 754 lymph nodes were harvested (median 13, range 0-28)
. Two hundred and twenty-eight positive nodes were found on histology (medi
an 4, range 1-23) in 43 (79%) patients with a higher incidence from T3/T4 t
han T1/T2 lesions (P < 0.003). Overall 1- and 3-year survival rates were 73
% and 47% respectively. Node positivity increased with increased total noda
l harvest, but was not influenced by the site of tumors or surgical approac
hes. There was no survival benefit for patients with < 20% over > 20% nodal
positivity (P = 0.31). Only negative lateral resection margin emerged as a
significant factor in both univariate (P < 0.01) and multivariate analysis
(P < 0.05). We conclude that the degree of nodal positivity in adenocarcin
oma is less important than resection margin status as a prognostic factor.