The role of lymphadenectomy in esophageal cancer.

Abstract

To address the role of lymphadenectomy in the treatment of esophageal cancer. The role of lymphadenectomy in esophageal cancer surgery is controversial, and there is a lack of uniformity as to what the term means. The published data was reviewed to evaluate the evidence base for, and the terminology associated with, lymphadenectomy for esophageal cancer. Recommendations are given for a standardization of terminology for radical and nonradical lymphadenectomy procedures. Although there is no doubt that the presence of lymph node metastases worsens prognosis for a patient, there is a lack of high-level evidence to support lymphadenectomy. Logically, the best procedure, from a staging and perhaps theoretical oncologic point of view, is a 3-field lymphadenectomy but it is not clear which patients, if any, are most likely to benefit. Well-designed randomized controlled trials are required to test, in a scientific manner, which of these procedures we should be offering our patients.