The assessment of prognosis of surgically resected oesophageal cancer is dependent on the number of lymph nodes examined pathologically
The assessment of prognosis of surgically resected oesophageal cancer is dependent on the number of lymph nodes examined pathologically
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DOI：
10.1111/j.1365-2559.2009.03332.x
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发表时间：
2009-07-01
期刊：
影响因子：
6.4
通讯作者：
Williams, Geriant T.
中科院分区：
文献类型：
--
作者：
Twine, Christopher P.;Lewis, Wyn G.;Williams, Geriant T.
目的：食道癌(OC)手术切除后的预后取决于受累区域淋巴结(LN)的数目，但对于组织病理学检查多少LN才能提供可靠的PN状态，目前尚无指导意见。这项研究的目的是确定OC切除后检查的淋巴结数量是否对预后评估有显著影响。方法和结果：对237例连续接受OC切除的患者的常规病理报告与生存的关系进行了检查和分析。主要的结果衡量标准是从确诊之日起的存活率。淋巴结数与生存密切相关，10个淋巴结计数后达到平台期。中位生存期和2年生存率分别为30个月和42%(n=88)，高于51个月和61%(P=0.005)。这种影响在pN0病例中最大。LN转移绝对数(<；4)和LN比率(<；0.4)的预后价值强烈依赖于>；10的LNC。结论：这些结果证实了OC切除后仔细的病理检查和淋巴结清扫的重要性。应检查至少10个节点以将OC指定为pN0。
Aims:The prognosis in surgically resected oesophageal carcinoma (OC) is dependent on the number of regional lymph nodes (LN) involved, but no guidance exists on how many LNs should be examined histopathologically to give a reliable pN status. The aim of this study was to determine whether the number of LNs examined after OC resection has a significant effect on the assessment of prognosis.Methods and results:Routinely generated pathology reports from 237 consecutive patients undergoing oesophagectomy for OC were examined and analysed in relation to survival. The main outcome measure was survival from date of diagnosis. Lymph node count (LNC) correlated strongly with survival; a plateau was reached after a count of 10. Median and 2-year survival was 30 months and 42%, respectively, if < 10 nodes were examined (n = 88), compared with 51 months and 61% if > 10 nodes were examined (P = 0.005). This effect was greatest in pN0 cases. The prognostic value of the absolute number of LN metastases (< 4) and LN ratio (< 0.4) was strongly dependent on a LNC of > 10.Conclusions:These results demonstrate the importance of careful pathological examination and lymph node retrieval after OC resection. At least 10 nodes should be examined to designate an OC as pN0.