Higher lymph node yield after neoadjuvant chemoimmunotherapy improves disease-free survival in esophageal squamous cell carcinoma, guiding surgical practices.

• Patients with no residual disease (ypt0-2n0) saw improved survival with 20-30 lymph nodes; benefits plateau beyond this range.
• In cases with residual disease (ypn1-3), higher yields correlated with longer disease-free survival.

Improving lymph node dissection may serve as a key quality indicator in surgical decision-making for this patient population.

• Lower lymph node yields consistently linked to worse disease-free survival across all stages.