386. ROLE OF RECURRENT NERVE LYMPHADENECTOMY THROUGH MINIMALLY INVASIVE SURGERY IN THE TREATMENT OF OESOPHAGEAL CANCER

Abstract

Abstract Background With the development of neoadjuvant therapy protocols and the advances in minimally invasive surgery, an increasing number of patients are undergoing surgery of oesophageal cancer. Lymphatic involvement is one of the most important independent prognostic factors. There is enough evidence to support that the greater the lymphadenectomy, the better survival rates. Our aim is to present the results of our series, in which partial or total recurrent nerve lymphadenectomy was performed during oncological oesophagectomies. Methods Retrospective observational study that includes all patients that were operated on for oesophageal cancer from January 2019 to January 2023. All surgeries were performed by the same specialized team. Quantitative variables are described as mean and standard deviation, and qualitative variables as absolute number and percentage. The univariate methods used were Pearson’s X2 or Student’s t test for independent samples. We used logistic regression models to study prognostic factors influencing survival. The IBM SPSS Statistics 22 programme was chosen for data analysis. Results 59 patients were operated during this period through minimally invasive approach, including recurrent nerve lymphadenectomy. Anatomopathological results showed 6 (10.2%) patients with recurrent lymph node involvement, 2 (3.4%) with right-sided positive nodes, 3 (5.1%) with left-sided ones and 1 (1.7%) with bilateral invasion. Analysis by subgroups showed that 20% of tumours larger than T2 had recurrent nerve lymph node metastasis. There were 18 (30.5%) recurrent nerve injuries, all of which were transient except for 3 (5.1%) that required scheduled surgery. A statistically significant relationship was found between the number of affected nodes and disease-free survival time (p-value = 0.045). Conclusions Mediastinal and recurrent nerve lymphadenectomy in oesophageal cancer increases the number of total positive lymph nodes obtained after surgery, allowing for a better adequacy of adjuvant treatment and corelating positively with disease-free survival time. Complications derived from these procedures are similar in number to standard lymphadenectomy and most of them can be managed by conservative treatment.