Nodal Skip Metastasis is not a Predictor of Survival in Thoracic Esophageal Squamous Cell Carcinoma
Nodal Skip Metastasis is not a Predictor of Survival in Thoracic Esophageal Squamous Cell Carcinoma
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DOI：
10.1245/s10434-013-2987-5
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发表时间：
2013-09-01
影响因子：
3.7
通讯作者：
Fu, Xiaolong
中科院分区：
文献类型：
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作者：
Zhu, Zhengfei;Yu, Weiwei;Fu, Xiaolong
结节跳跃转移(NSM)的存在在非小细胞肺癌中具有重要的临床意义，但对食道癌这种现象的研究相对较少。本研究旨在探讨胸段食管鳞癌(ESCC)中影响NSM的危险因素及其预后价值。用Logistic回归分析评价NSM的发生与患者临床病理特征及原发肿瘤的关系。NSM对总生存期(OS)的影响通过对数等级检验和COX回归分析进行评估。除原发肿瘤的部位外，其他因素与NSM的发生无明显相关性。29例上胸段食管鳞癌患者均未发现NSM，中、下1/3段食管区肿瘤发生率分别为38.9%和14.9%。中位OS为30个月，有无NSM患者OS差异无统计学意义(P=0.767)。COX多因素分析发现，仅N状态是OS的独立危险因素。NSM在胸段ESCC中很常见，尤其是位于食道中下1/3的肿瘤。然而，NSM的存在并不能预测预后。
The presence of nodal skip metastasis (NSM) has been found to be of clinical importance in non-small cell lung cancer, but the study of this phenomenon in esophageal carcinoma is relatively rare. The purpose of this study was to identify risk factors influencing NSM and to assess its prognostic value in thoracic esophageal squamous cell carcinoma (ESCC).A total of 207 patients with thoracic ESCC who underwent three-field lymphadenectomy and who had lymph node metastasis were reviewed. Associations of NSM occurrence with the clinicopathological characteristics of patients and primary tumors were evaluated using logistic regression analysis. The influence of NSM on the overall survival (OS) was assessed by log-rank tests and Cox regression analysis.NSM were present in 58 (26 %) patients. No factor was significantly associated with the incidence of NSM except for the location of primary tumor. There were no NSMs in the 29 patients from our study with upper thoracic ESCC, and the rates of tumors occurrence in the middle and lower third of the esophagus were 38.9 and 14.9 %, respectively. The median OS was 30 months, and no significant difference in OS was found between the patients with or without NSM (p = 0.767). Only N status was found to be the independent risk factor for OS by Cox multivariate analysis.NSM is common in thoracic ESCC, especially in patients with tumors located in the middle and lower third of the esophagus. However, the presence of NSM did not predict prognosis.