The Number of Pathologic Lymph Nodes Involved is Still a Significant Prognostic Factor Even After Neoadjuvant Chemoradiotherapy in Esophageal Squamous Cell Carcinoma
The Number of Pathologic Lymph Nodes Involved is Still a Significant Prognostic Factor Even After Neoadjuvant Chemoradiotherapy in Esophageal Squamous Cell Carcinoma
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DOI：
10.1002/jso.23007
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发表时间：
2012-06-01
影响因子：
2.5
通讯作者：
Matsubara, Hisahiro
中科院分区：
文献类型：
--
作者：
Akutsu, Yasunori;Shuto, Kiyohiko;Matsubara, Hisahiro
背景：新辅助放化疗(NACRT)后食管鳞状细胞癌(ESCC)患者的病理转移淋巴结数目与手术结果之间的相关性鲜有报道。方法：对88例接受NACRT和手术治疗的ESCC患者的临床资料进行分析。评估NACRT的临床疗效，并对原发肿瘤和切除的LN的手术标本进行临床病理分析。结果：较少的病理转移的LN与较好的生存相关。根据转移性淋巴结数目，将患者分为2个和3个转移性淋巴结转移组的中位生存期差异最大(X~2=13.694，P<0.001)。在临床因素方面，单因素分析显示，治疗前的初始状态对生存率的影响最显著(P=0.064)，而病理性转移淋巴结数目是预后不良的危险因素，经多因素分析，危险比为5.128(95%可信区间：1.438~18.285，P=0.012)。结论：在各种因素中，病理性转移淋巴结数目是预测患者生存的最强指标。J·奥科尔外科医生。2012年；105：756-760。(C)2011年威利期刊公司。
Background: The correlation between the number of pathologic metastatic LNs in patients with esophageal squamous cell carcinoma (ESCC) after neoadjuvant chemoradiotherapy (NACRT) and surgical outcome has rarely been reported. We evaluated the correlation between the number of pathologic metastatic lymph nodes (LNs) and the surgical outcome in ESCC after NACRT.Methods: Eighty-eight patients with ESCC who underwent NACRT followed by surgery were evaluated. The clinical response of NACRT was evaluated and surgical specimens of the primary tumor and resected LNs were analyzed clinicopathologically.Results: Fewer pathologic metastatic LNs was associated with better survival. According to the number of metastatic LNs, the difference in the median survival was the largest between the groups when patients were divided into those with 2 and 3 metastatic LNs (chi(2): 13.694, P < 0.001). With regard to clinical factors, the initial N status prior to treatment had the most significant impact on survival by a univariate analysis (P = 0.064), and the number of pathologic metastatic LNs was a risk factor for poor survival, with a hazard ratio of 5.128 (95% C.I.: 1.438-18.285, P = 0.012) by a multivariate analysis.Conclusions: Of the various factors, the number of pathologic metastatic LNs was the strongest indicator to predict the patients' survival. J. Surg. Oncol. 2012; 105:756-760. (C) 2011 Wiley Periodicals, Inc.