Prognostic Value of Subcarinal Lymph Nodes in Minimally Invasive Esophagectomy for Cancer

Abstract

Background/aim: Surgical resection for esophageal cancer has remained the gold-standard therapy provided worldwide. Subcarinal lymph-nodes are classified as peri-esophageal nodes and their dissection may be performed during a 2- or 3-stage esophagectomy. The necessity and prognostic value of subcarinal lymphadenectomy is still debatable. The purpose of this study was to investigate the rate of invaded subcarinal lymph-nodes out of the total lymph-nodes resected. Detection of invaded nodes was correlated with clinical staging and tumor differentiation.

Patients and methods: This is a retrospective analysis of consecutive esophagectomies for cancer, performed in a UK tertiary center. The study was conducted over a 3-year period.

Results: The rate of subcarinal lymph-node invasion was extremely low according to the results of our analysis.

Conclusion: Lymphadenectomy is not devoid of clinical impact on patients and therefore, the decision should actually be the outcome of a dynamic balance between complications and survival benefit.

Keywords: Subcarinal; esophageal cancer; lympadenectomy; minimally-invasive.