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OBJECTIVE To clarify whether systemic lymph node dissection (LND) influences the safety of surgery and the survival of patients with locally advanced esophageal squamous cell carcinoma (ESCC) after neoadjuvant chemoradiotherapy (nCRT). SUMMARY BACKGROUND DATA Prognostic impact of systemic lymphadenectomy during surgery after nCRT for ESCC is still uncertain and requires clarification. METHODS This is a secondary analysis of NEOCRTEC5010 trial which compared nCRT followed by surgery versus surgery alone for locally advanced ESCC. Relationship between number of LND and perioperative, recurrence and survival outcomes were analyzed in the nCRT group. RESULTS Three-year overall survival was significantly better in the nCRT group than the S group (75.2% vs 61.5%; P=0.011). In the nCRT group, greater number of LND was associated with significantly better overall survival (HR, 0.358; P < 0.001) and disease-free survival (HR, 0.415; P=0.001), but without any negative impact on postoperative complications. Less LND (< 20 vs ≥ 20) was significantly associated with increased local recurrence (18.8% vs 5.2%, P=0.004) and total recurrence rates (41.2% vs 25.8%, P=0.027). Compared to patients with persistent nodal disease, significantly better survival was seen in patients with complete response and with LND ≥ 20, but not in those with LND < 20. CONCLUSIONS Systemic lymph node dissection does not increase surgical risks after nCRT in ESCC patients. And it is associated with better survival and local disease control. Therefore, systemic lymphadenectomy should still be considered as an integrated part of surgery after nCRT for ESCC.

Currently, cucumber cultivation is mainly through monoculture, as continuous culture leads to the decrease of crop yield and soil quality. In order to improve soil quality to achieve continuous monocultures, soil physicochemical properties, microbial biomass, content of phenolic compounds, and the size of bacterial, fungal, ammonia-oxidizing bacteria (AOB), and Fusarium oxysporum were first evaluated in cucumber monoculture solar greenhouse. Soil improvement technology, including catch wheat (CW), calcium cyanamide disinfection (LN), and straw reactor technology (SR) during summer fallow period, was compared with conventional fallow (CK). Results showed that CW, LN, and SR all significantly increased soil pH, and LN and SR increased soil electrical conductivity (EC); however, CW decreased soil EC. Meanwhile, LN increased soil available N content significantly and SR increased available P content significantly. CW had negative effect on the accumulation of soil available nutrients, conversely, CW and SR had positive effect on the accumulation of microbial biomass carbon (MBC). All the treatments increased the total phenol content in the soil compared with CK. While CW increased the size of bacteria, AOB in the soil inhibited fungal and wilt pathogen size. LN also increased the size of soil bacteria and reduced the size of fungi. The comprehensive evaluation of all treatments showed that CW could control soil nutrient loss and improve the continuous cropping soil, making the soil transform from fungi to bacteria type. All the treatments accelerate the accumulation of phenolic compound, while whether or not developing autotoxicity requires further investigation.

Currently, cucumber cultivation is mainly through monoculture, as continuous culture leads to the decrease of crop yield and soil quality. In order to improve soil quality to achieve continuous monocultures, soil physicochemical properties, microbial biomass, content of phenolic compounds, and the size of bacterial, fungal, ammonia-oxidizing bacteria (AOB), and Fusarium oxysporum were first evaluated in cucumber monoculture solar greenhouse. Soil improvement technology, including catch wheat (CW), calcium cyanamide disinfection (LN), and straw reactor technology (SR) during summer fallow period, was compared with conventional fallow (CK). Results showed that CW, LN, and SR all significantly increased soil pH, and LN and SR increased soil electrical conductivity (EC); however, CW decreased soil EC. Meanwhile, LN increased soil available N content significantly and SR increased available P content significantly. CW had negative effect on the accumulation of soil available nutrients, conversely, CW and SR had positive effect on the accumulation of microbial biomass carbon (MBC). All the treatments increased the total phenol content in the soil compared with CK. While CW increased the size of bacteria, AOB in the soil inhibited fungal and wilt pathogen size. LN also increased the size of soil bacteria and reduced the size of fungi. The comprehensive evaluation of all treatments showed that CW could control soil nutrient loss and improve the continuous cropping soil, making the soil transform from fungi to bacteria type. All the treatments accelerate the accumulation of phenolic compound, while whether or not developing autotoxicity requires further investigation.

Most patients with esophageal cancer have advanced disease at presentation. The efficacy of surgical resection alone is often unsatisfactory in patients with stage III or more advanced cancer according to the seventh edition of UICC staging system for esophageal cancer. The systematic multidisciplinary treatment is important. Mounting evidence indicates that preoperative concurrent chemoradiotherapy is the most effective induction therapy to down-stage tumor and increase radical resection rate. For the esophageal squamous cell carcinoma patients with multi-stations and multi-fields lymph node metastasis, preoperative induction chemotherapy would be a viable option. For locally advanced cancers which have been surgically resected, postoperative adjuvant radiotherapy maybe helpful to improve local control for the insufficient surgical dissection. The role of adjuvant chemotherapy also needs further studies. Thoracic esophageal squamous cell carcinoma and lower esophageal adenocarcinoma which is common in western countries are different. We need more prospective clinical studies to establish our treatment modalities for esophageal cancer.