A lot of progress has been made in the last 20 years in the treatment of esophageal cancer, mostly owing to the introduction of neoadjuvant therapy and to a decrease in morbidity and mortality achieved by expert surgeons who work in high-volume centers. However, stage by stage, the prognosis of this cancer has not changed much over the years, and surgery is still the mainstay of treatment. To improve survival, surgeons have been exploring the role of a more extensive resection and, in particular, the role of a more extensive lymphadenectomy. This technical aspect remains today one of the most controversial issues in the treatment of esophageal cancer. The basic questions are still the same: does an extended lymphadenectomy increase survival? And in the absence of a definitive answer, is the increased morbidity and mortality justified?
Patti MG. Survival After Lymphadenectomy in Patients With Esophageal CancerA Controversial Issue. JAMA Surg. 2016;151(1):40. doi:10.1001/jamasurg.2015.2599