The number of resected lymph nodes from the upper mediastinal area predicts long-term outcomes of esophageal squamous cell carcinoma after minimally invasive esophagectomy

被引：4

作者：

Koterazawa, Yasufumi ^{[1
]}

Goto, Hironobu ^{[1
]}

Saiga, Hiroshi ^{[1
]}

Kato, Takashi ^{[1
]}

Sawada, Ryuichiro ^{[1
]}

Harada, Hitoshi ^{[1
]}

Urakawa, Naoki ^{[1
]}

Hasegawa, Hiroshi ^{[1
]}

Kanaji, Shingo ^{[1
]}

Yamashita, Kimihiro ^{[1
]}

Matsuda, Takeru ^{[1
]}

Oshikiri, Taro ^{[2
]}

Kakeji, Yoshihiro ^{[1
]}

机构：

[1] Kobe Univ, Grad Sch Med, Dept Surg, Div Gastrointestinal Surg, 7-5-2 Kusunoki Cho,Chuo Ku, Kobe, Hyogo 6500017, Japan

[2] Ehime Univ, Div Gastrointestinal Surg & Surg Oncol, Grad Sch Med, Toon, Ehime 7910295, Japan

来源：

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2024年 / 38卷 / 07期

关键词：

Esophageal squamous cell carcinoma; Minimally invasive esophagectomy; Resected lymph node count; PROGNOSTIC-FACTORS; CANCER; SURVIVAL; LYMPHADENECTOMY; JUNCTION; THERAPY; SOCIETY; SURGERY;

D O I：

10.1007/s00464-024-10853-4

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

BackgroundThe total number of resected lymph nodes (LNs) is an important determinant of longer survival after esophagectomy for esophageal squamous cell carcinoma (ESCC). However, the resected LN counts from areas that affect long-term outcomes remain unclear.MethodsThis study included 406 patients who underwent minimally invasive esophagectomies (MIEs) at Kobe University Hospital. Resected LN counts were evaluated in the following areas: upper mediastinal (UM), middle mediastinal (MM), lower mediastinal (LM), and abdominal (Abd). Cut-off values for LN counts from each area were determined using receiver operating characteristics analysis of the survival status. Cox proportional hazards regression analyses were performed to identify prognostic factors.ResultsThe cut-off values for large or small numbers of resected LN counts in the UM, MM, LM, and Abd areas were 4, 8, 5, and 18, respectively, in patients with upper and middle thoracic (Ut/Mt) ESCC and 7, 6, 5, and 24, respectively, in patients with lower thoracic (Lt) ESCC. Multivariate analysis in patients with Ut/Mt ESCC revealed that tumor invasion depth, LN metastasis, and the resected LN count from the UM area were independent risk factors for overall survival [hazard ratio (HR), 7.04; 95% confidence interval (CI) 4.47-11.1; HR, 4.01; 95% CI 1.96-8.21; HR, 2.18; 95% CI 1.24-3.82, respectively]. In patients with Lt ESCC, tumor invasion depth, LN metastasis, and pulmonary complications were independent risk factors for overall survival (HR, 4.23; 95% CI 2.14-8.35; HR, 3.83; 95% CI 1.75-8.38; HR, 2.80; 95% CI 1.38-5.65, respectively). Resected LN counts from no areas were prognostic factors.ConclusionThe number of resected LNs from the UM area influenced the survival outcomes of patients with Ut/Mt ESCC after MIE.

引用

页码：3625 / 3635

页数：11

共 33 条

[1] Total number of resected lymph nodes predicts survival in esophageal cancer [J].