Effect of Neoadjuvant Chemoradiotherapy on Lymph Node Micrometastases in Thoracic Esophageal Cancer
Effect of Neoadjuvant Chemoradiotherapy on Lymph Node Micrometastases in Thoracic Esophageal Cancer
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DOI：
10.21873/anticanres.12299
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发表时间：
2018-02-01
影响因子：
2
通讯作者：
Natsugoe, Shoji
中科院分区：
文献类型：
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作者：
Yanagi, Masayuki;Sasaki, Ken;Natsugoe, Shoji
目的：探讨新辅助放化疗(NCRT)对食管鳞癌(ESCC)淋巴结微转移的影响。患者和方法：将41例ESCC患者随机分为手术组(n=21)和nCRT组(n=20)，分析其治疗效果。采用免疫组织化学方法将患者的淋巴组织标本分为微转移(MM)和肿瘤细胞微侵犯(MI)两类。结果：手术组MM合并或不合并MI或单纯MI的发生率明显高于nCRT组。同时发生组织学转移的15例患者的10年生存率明显低于26例无淋巴结转移的患者。在nCRT组中，HM组与非HM组患者的10年生存率无显著差异，但同时发生HM和LNM的5例患者的10年生存率显著低于15例无LNM的患者。结论：伴LNM的ESCC患者可能受益于nCRT，评估HM和LNM同时存在有助于准确预测ESCC患者的生存。
Aim: The purpose of this study was to clarify the effect of neoadjuvant chemoradiotherapy (nCRT) on lymph node micrometastasis (LNM) in esophageal squamous cell carcinoma (ESCC). Patients and Methods: The therapeutic efficacy of nCRT was analyzed in 41 ESCC patients randomized to the Surgery group (n=21) and the nCRT group (n=20). Lymph node specimens from patients were classified into two categories, micrometastasis (MM) and tumor cell microinvolvement (MI), after immunohistochemical evaluation. Results: The incidence rates of patients presenting MM with or without MI or MI alone in the Surgery group were significantly higher than those in the nCRT group. The 10-year survival rate of 15 patients with simultaneous histological metastasis (HM) and LNM was significantly lower than that in the 26 patients without LNM. Within the nCRT group, the 10-year survival rates of patients with versus those without HM were not significantly different; however, the 10-year survival rate of the 5 patients with simultaneous HM and LNM was significantly lower than that of the 15 patients without LNM. Conclusion: ESCC patients with LNM may benefit from nCRT, and evaluation of the simultaneous presence of HM and LNM may facilitate accurate prediction of survival in ESCC patients.