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Updated: May 2, 2026
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Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
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Lymph node yield and its impact on survival outcomes: a retrospective multicenter cohort study from Denmark
Oliver Nørholm Kempf1, Lise Bech Jellesmark Thorsen2, Nikolaj Nerup1
1Department of Digestive Diseases, Transplantation and General Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Summary
Higher lymph node (LN) yield improves survival for node-negative esophageal cancer patients. For node-positive esophageal and gastric cancers, survival benefits plateau beyond 16-19 lymph nodes removed.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- The prognostic significance of lymph node (LN) yield in esophageal and gastric cancer surgery is debated, particularly with evolving perioperative treatments.
- Accurate staging and adequate LN dissection are crucial for predicting outcomes in upper gastrointestinal cancers.
Purpose of the Study:
- To investigate the association between lymph node yield and survival outcomes in patients with esophageal and gastric cancer undergoing curative resection.
- To evaluate the impact of perioperative chemotherapy on survival based on nodal status and LN yield.
Main Methods:
- A multicenter cohort study of 3092 patients with esophageal (n=2402) or gastric cancer (n=690) between 2013-2021.
- Utilized the Danish Esophagogastric Cancer Group database, ensuring comprehensive data coverage.
- Employed Kaplan-Meier curves and multivariable Cox regression for survival analyses, stratifying by nodal status and LN yield.
Main Results:
- In node-negative esophageal cancer, higher LN yields (≥20) were significantly associated with improved survival compared to yields of 16-19 nodes.
- No significant survival benefit was observed for node-positive esophageal or gastric cancers with LN yields exceeding 16-19 nodes.
- Perioperative chemotherapy improved survival in node-positive esophageal cancer but not in node-negative esophageal or gastric cancers. Frequent discrepancies between clinical and pathological nodal staging were noted.
Conclusions:
- Lymph node yield is a significant prognostic factor, particularly for node-negative esophageal cancer, where removing ≥20 nodes improves survival.
- For node-positive esophageal and gastric cancers, the survival benefit of LN yield appears to plateau after 16-19 nodes.
- Discrepancies in nodal staging highlight the need for improved preoperative diagnostics and underscore the influence of perioperative chemotherapy on treatment allocation and outcomes.
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