Extension of lymph node dissection in the surgical treatment of esophageal and gastroesophageal junction cancer: seven questions and answers

• Published in: Future oncology (London, England) Vol. 19; no. 4; pp. 327 - 339
• Main Authors: Vagliasindi, Alessio, Franco, Filippo Di, Degiuli, Maurizio, Papis, Davide, Migliore, Marcello
• Format: Journal Article
• Language: English
• Published: England Future Medicine Ltd 01-02-2023
• Subjects: esophageal cancer; Esophageal Neoplasms - pathology; Esophagectomy; Esophagogastric Junction - pathology; Esophagogastric Junction - surgery; gastroesophageal junctional cancer; Humans; Ivor Lewis esophagectomy; Lymph Node Excision; Lymph Nodes - pathology; Lymph Nodes - surgery; lymphadenectomy; minimally invasive surgery; Neoplasm Staging; nodal dissection; robotic esophagectomy; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; three-field nodal dissection; two-field nodal dissection; VATS; nodal dissection; VATS; gastroesophageal junctional cancer; esophageal cancer; two-field nodal dissection; minimally invasive surgery; esophagectomy; robotic esophagectomy; Ivor Lewis esophagectomy; lymphadenectomy; three-field nodal dissection
• ISSN: 1479-6694; 1744-8301
• DOI: 10.2217/fon-2021-0545

The role of two- or three-field nodal dissection in the surgical treatment of esophageal and gastroesophageal junction cancer in the minimally invasive era is still controversial. This review aims to clarify the extension of nodal dissection in esophageal and gastroesophageal junctional cancer. A basic evidence-based analysis was designed, and seven research questions were formulated and answered with a narrative review. Reports with little or no data, single cases, small series and review articles were not included. Three-field lymph node dissection improves staging accuracy, enhances locoregional disease control and might improve survival in the group of patients with cervical and upper mediastinal metastatic lymph nodal involvement from middle and proximal-third esophageal cancer.