{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T07:24:54Z","timestamp":1744097094796,"version":"3.37.3"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,5,25]],"date-time":"2017-05-25T00:00:00Z","timestamp":1495670400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Lymph node (LN) involvement by esophageal cancer is associated with compromised long\u2010term prognosis. This study assessed whether LN downstaging by neoadjuvant treatment (NAT) might offer a survival benefit compared to patients with a priori negative LN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients undergoing esophagectomy for cancer between 2005 and 2014 were screened for inclusion. Group 1 included cN0 patients confirmed as pN0 who were treated with surgery first, whereas group 2 included patients initially cN+ and down\u2010staged to ypN0 after NAT. Survival analysis was performed with the Kaplan\u2010Meier and Cox regression methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010seven patients were included in our study, 24 in group 1 and 33 in group 2. Group 2 patients had more locally advanced lesions compared to a priori negative patients, and despite complete LN sterilization by NAT they still had worse long\u2010term survival. Overall 3\u2010year survival was 86.8% for a priori LN negative versus 63.3% for downstaged patients (<jats:italic>P<\/jats:italic>\u2009=\u20090.013), while disease\u2010free survival was 79.6% and 57.9%, respectively (<jats:italic>P<\/jats:italic>\u2009=\u20090.021). Tumor recurrence was also earlier and more disseminated for the down\u2010staged group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Downstaged LN, despite the systemic effect of NAT, still inherit an increased risk for early tumor recurrence and worse long\u2010term survival compared to a priori negative LN.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.24689","type":"journal-article","created":{"date-parts":[[2017,5,25]],"date-time":"2017-05-25T20:46:42Z","timestamp":1495745202000},"page":"524-532","source":"Crossref","is-referenced-by-count":3,"title":["Sterilization of tumor\u2010positive lymph nodes of esophageal cancer by neo\u2010adjuvant treatment is associated with worse survival compared to tumor\u2010negative lymph nodes treated with surgery 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