Robotic thoracoscopic left paratracheal and cervical lymphadenectomy for recurrent esophageal adenocarcinoma: A case report

Despite advancements in surgical techniques and perioperative care, approximately 50 % of patients treated with curative esophagectomy for esophageal cancer will develop recurrence. To date, there is an absence of guidelines for the management of regional lymph node recurrence, reflecting a lack of quality data in the literature. We present the case of a 59-year-old female who experienced an oligometastatic recurrence involving the level 2 L left paratracheal and level III left cervical nodal stations, after previous perioperative chemotherapy and minimally invasive esophagectomy for esophageal adenocarcinoma four months earlier. The patient was treated with robotic-assisted paratracheal and cervical lymphadenectomy using the Da Vinci XI system. Postoperatively, the patient recovered uneventfully, and short-term follow-up demonstrated no residual disease. This case highlights the complexity of managing recurrent esophageal cancer and the potential role of robotic surgical strategies in improving patient outcomes in the context of oligometastatic recurrence. Additionally, it underscores the need for further research to refine surgical techniques and case selection, and to establish guidelines for the treatment of recurrent esophageal cancer. Robotic-assisted lymphadenectomy represents a feasible option for managing locoregional recurrence of esophageal adenocarcinoma in select cases. Multidisciplinary team involvement remains critical to individualized treatment planning.