Dissection of lymph node metastases in esophageal cancer

There has been much recent debate regarding the best surgical procedure to treat esophageal cancer, in particular with regard to the optimum extent of lymphadenectomy to improve survival while minimizing morbidity. No results obtained by prospective, randomized studies on the comparison of radical esophagectomy and extended lymphadenectomy with limited or less invasive resections following neoadjuvant therapy with regard to perioperative morbidity and prognosis are available to date. Until now, there has been no evidence suggesting the usefulness of sentinel lymph node navigation in esophageal cancers, regardless of the cell type. Furthermore, the question as to the benefits and risks of two-field and three-field lymphadenectomy in esophageal cancer has not yet been conclusively answered. This article will discuss the recent status of lymph node-dissection procedures stage-dependently according to the two different tumor entities and with regard to minimally invasive esophagectomy, including the novel 2010 Tumor, Node, Metastasis-staging system.