The Annals of thoracic surgery · 2026
Prognosis of Isolated Cervical Node Recurrence After Esophagectomy With Two-Field Lymphadenectomy for Esophageal Squamous Cell Carcinoma.
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Jeon Yeong Jeong, Son Jeong A, Lee Junghee, Park Seong Yong, Cho Jong Ho, Choi Yong Soo, Shim Young Mog, Sun Jong-Mu, Park Sehhoon, Oh Dongryul, Kim Hong Kwan
Аннотация
BACKGROUND: Three-field lymph node dissection during esophagectomy for thoracic esophageal squamous cell carcinoma is controversial because of higher morbidity and uncertain survival benefits compared with 2-field lymph node dissection (2FL). Isolated cervical/supraclavicular lymph node recurrence (ICLNR) after 2FL shows better prognosis than other recurrences. We investigated clinical features and prognosis of ICLNR after 2FL.
METHODS: This retrospective study analyzed patients with recurrence after upfront esophagectomy with 2FL for mid to lower thoracic esophageal squamous cell carcinoma. The primary end point was overall survival (OS); the secondary end point was post-recurrence survival.
RESULTS: Of 550 patients experiencing recurrence, ICLNR occurred in 69 cases (12.5%). Patients with ICLNR demonstrated better 5-year OS than patients with other recurrences (38.1% vs 22.2%; P = .002). Three-year post-recurrence survival was 62.5% after surgery, 61.4% after chemoradiotherapy, 38.4% after chemotherapy, and 32.5% after radiotherapy. Longer disease-free interval and definitive local salvage were associated with better OS.
CONCLUSIONS: ICLNR after 2FL showed favorable outcomes with definitive local salvage treatment. Prospective multicenter studies are needed to clarify optimal management of ICLNR.
METHODS: This retrospective study analyzed patients with recurrence after upfront esophagectomy with 2FL for mid to lower thoracic esophageal squamous cell carcinoma. The primary end point was overall survival (OS); the secondary end point was post-recurrence survival.
RESULTS: Of 550 patients experiencing recurrence, ICLNR occurred in 69 cases (12.5%). Patients with ICLNR demonstrated better 5-year OS than patients with other recurrences (38.1% vs 22.2%; P = .002). Three-year post-recurrence survival was 62.5% after surgery, 61.4% after chemoradiotherapy, 38.4% after chemotherapy, and 32.5% after radiotherapy. Longer disease-free interval and definitive local salvage were associated with better OS.
CONCLUSIONS: ICLNR after 2FL showed favorable outcomes with definitive local salvage treatment. Prospective multicenter studies are needed to clarify optimal management of ICLNR.