The ratio of metastic lymph nodes to total number of nodes resected is prognostic for survival after en bloc lymphadenectomy in oesophageal carcinoma

Introduction: The extent of lymphadenectomy in oesophageal cancer surgery may affect prognosis, and the role of the number of nodes affected by tumour is of interest. We assess predictors of survival with oesophagectomy and systematic 2-field lymphadenectomy for oesophageal and gastro-oesophageal junction malignancy
Methods: Prospective data was collected for 178 consecutive patients with oesophageal malignancy undergoing oesophagectomy and systematic lymphadenectomy between 1991 and 2004 in a tertiary referral unit. One hundred and thirteen patients (64%) had adenocarcinoma, 54 (30%) squamous cell carcinoma and 11 (6%) were other tumour types (3 small cell carcinomas). Data was analysed with Kaplan-Meier method, Log Rank test and Cox’s proportional hazards regression for survival analysis.
Results: Median age was 67 years (range 29-84years), with 124 males (70%). Kaplan-Meier 5-year survival was 42% with hospital mortality of 3.3%. RO was achieved in 87%, R1 in 10% and R2 in 3%. Locoregional recurrence occurred in 12%. There was no association between overall survival and tumour site (p=0.96) or histological type (p=0.16). The total number of affected nodes significantly reduced survival, as did an increasing ratio of invaded nodes to the number of nodes resected (p


Session: Poster

Program Number: P285

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