Salvage Lymphadenectomy Without Esophagectomy is an Option for Recurrent or Residual Lymph Nodes after Definitive Chemoradiotherapy for Esophageal Cancer

Purposes The aim of this study was to determine the prognostic factors in salvage surgery following definitive chemoradiotherapy (dCRT) for esophageal cancer.Methods We retrospectively reviewed twenty-five patients who underwent salvage surgery from 1986 to 2011 at Kurume University Hospital.Results Esophagectomy was adopted for 20 patients, while lymphadenectomy alone without esophagectomy was adopted for the other 5 patients. Univariate analysis found that age, response to initial treatment, presence of residual tumor, pT after salvage surgery, and severe complications were each significantly correlated with overall survival after salvage surgery. The type of surgery (esophagectomy vs lymphadenectomy) and presence of residual tumor (R) were each determined to be an independent prognostic factor by the multivariate analysis. Namely, the prognosis after R0 resection was better than that after R1/2 resection (HR 18.050, p <0.0001), and the prognosis after salvage lymphadenectomy was better than that after salvage esophagectomy (HR 5.091, p = 0.0086).Conclusions Salvage lymphadenectomy without esophagectomy is suggested to be an option for patients having recurrent or residual lymph nodes without any other recurrence or residual tumor after dCRT for esophageal cancer.