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Abstract
Lymph node metastases are a major prognostic factor in survival of patients with oesophageal cancer. The number of lymph nodes removed during oesophagectomy has been previously proven to be associated with improved survival. The aim of this study was to examine the effect of lymph node harvest on survival specifically in pathologically node negative (pN0) patients with oesophageal cancer. Data were extracted from a prospectively populated single-surgeon database of oesophageal resections for cancer. All consecutive patients with pN0 were included. Patient-specific risk adjusted analysis of overall and disease-free survival was performed to identify the number of lymph nodes associated with improved survival. Inclusion criteria were met by 137 patients (49 squamous cell carcinoma and 88 adenocarcinoma). Adjusted for cancer stage, tumour (histological type, degree of differentiation, lympho-vascular invasion, neo-adjuvant therapy) and patient related factors (age, sex), increased lymph node number was associated with significant improvement in overall (P = 0.045) and disease free (P = 0.030) survival. Lymph node count ≥ 17 was associated with improved overall and disease-free survival. In this cohort of patients with pathologically node-negative oesophageal cancer, lymph node count of 17 or above was associated with significantly improved survival.
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1 University of Notre Dame, School of Medicine, Sydney, Australia (GRID:grid.266886.4) (ISNI:0000 0004 0402 6494); Concord Repatriation General Hospital, Upper GI Surgery, Concord, Australia (GRID:grid.414685.a) (ISNI:0000 0004 0392 3935)
2 University of Sydney, Discipline of Surgery, Faculty of Medicine and Health, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X)
3 Strathfield Private Hospital, Upper GI Surgery, Strathfield, Australia (GRID:grid.414685.a); Sydney Adventist Hospital, Upper GI Surgery, Wahroonga, Australia (GRID:grid.416787.b) (ISNI:0000 0004 0500 8589); University of Sydney, Discipline of Surgery, Faculty of Medicine and Health, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X)
4 Concord Repatriation General Hospital, Upper GI Surgery, Concord, Australia (GRID:grid.414685.a) (ISNI:0000 0004 0392 3935); Sydney Heartburn Clinic, Lindfield, Australia (GRID:grid.414685.a); University of Sydney, Discipline of Surgery, Faculty of Medicine and Health, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X)