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. Author manuscript; available in PMC: 2018 Aug 1.
Published in final edited form as: Thorac Surg Clin. 2017 Aug;27(3):227–244. doi: 10.1016/j.thorsurg.2017.04.001

Table 11.

A Summary of Studies Supporting Increased Extent of Lymphadenectomy

Study Design
Year of Study		 Number of Patients Recommendations
WECC Guidelines for lymphadenectomy predict survival following neoadjuvant therapy47 Prospective cohort (2012) 135 >10 for T1 or less
>20 for T2
>30 for T3/4
Optimum lymphadenectomy for esophageal cancer46 Retrospective review from WECC database (2010) 4627 For N0 cancers:

  • 10–12 for pT1

  • 15–22 for pT2

  • 31–42 for pT3/4
For N1-2 cancers:

  • 10 for pT1

  • 15 for pT2

  • 29–50 for pT3/4

Total number of lymph nodes predicts survival in esophageal cancer50 Retrospective review of single institution database (2008) 264 Overall survival improved with increasing lymphadenectomy
The Number of Lymph Nodes Removed Predicts Survival in Esophageal Cancer: An International Study on the Impact of Extent of Surgical Resection48 Retrospective database review, data compiled from 9 international centers (2008) 2303 > 23 lymph nodes
Effects of the Number of Lymph Nodes Sampled on Postoperative Survival of Lymph Node-Negative Esophageal Cancer52 Retrospective database review based on SEER (2008) 972 >18 lymph nodes
Clinical Impact of Lymphadenectomy Extent in Resectable Esophageal Cancer49 Retrospective database review based on SEER (2007) 2597 >30 lymph nodes
>15 negative lymph nodes
The prognostic importance of the number of involved lymph nodes in esophageal cancer: implications for revision of the AJCC staging system53 Retrospective review, single institution (2006) 336 >18 lymph nodes for diagnostic accuracy
Staging of Esophageal Carcinoma: Length of Tumor and Number of Involved Regional Lymph Nodes. Are These Independent Prognostic51 Single institution study (2006) 213 >15 negative lymph nodes

Data from Refs 46–53