A multicenter study shows that removing at least 25 lymph nodes during surgery for esophageal adenocarcinoma post-chemotherapy leads to better outcomes.

• An optimal yield of 25 nodes resulted in a 29% reduction in mortality (HR: 0.714, p=0.0017) for chemotherapy patients.
• Those with ≥25 lymph nodes had approximately 44% lower mortality compared to chemoradiotherapy cases (HR=0.563, p<0.001).

Surgeons should prioritize radical lymphadenectomy with sufficient node yield to improve survival rates in this patient population.

• Disease recurrence was lower in chemotherapy patients (32.7%) compared to chemoradiotherapy (38.3%, p=0.001).