Prognostic Value of Subcarinal Lymph Node Metastasis in Patients with Esophageal Squamous Cell Carcinoma

被引:22
作者
Feng, Ji-Feng [1 ,2 ]
Zhao, Qiang [1 ,2 ]
Chen, Qi-Xun [1 ,2 ]
机构
[1] Zhejiang Canc Hosp, Dept Thorac Surg, Hangzhou, Zhejiang, Peoples R China
[2] Key Lab Diag & Treatment Technol Thorac Oncol, Hangzhou, Zhejiang, Peoples R China
关键词
Esophageal cancer; lymph node; prognostic factor; survival; CANCER; SURVIVAL; PATTERN; DISEASE; SPREAD; NUMBER;
D O I
10.7314/APJCP.2013.14.5.3183
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: The 7th edition of the American Joint Committee on Cancer Staging Manual for esophageal cancer (EC) categorizes N stage according to the number of metastatic lymph nodes (LNs), irrespective of the site. The aim of this study was to determine the prognostic value of subcarinal LN metastasis in patients undergoing esophagectomy for esophageal squamous cell carcinoma (ESCC). Methods: A retrospective analysis of 507 consecutive patients with ESCC was conducted. Potential clinicopathological factors that could influence subcarinal LN metastasis were statistically analyzed. Univariate and multivariate analyses were also performed to evaluate the prognostic parameters for survival. Results: The frequency of subcarinal LN metastasis was 22.9% (116/507). Logistic regression analysis showed that tumor length (>3cm vs <= 3cm; P=0.027), tumor location (lower vs upper/middle; P=0.009), vessel involvement (Yes vs No; P=0.001) and depth of invasion (T3-4a vs T1-2; P=0.012) were associated with 2.085-, 1.810-, 2.535- and 2.201-fold increases, respectively, for risk of subcarinal LN metastasis. Multivariate analyses showed that differentiation (poor vs well/moderate; P=0.001), subcarinal LN metastasis (yes vs no; P=0.033), depth of invasion (T3-4a vs T1-2; P=0.014) and N staging (N1-3 vs N0; P=0.001) were independent prognostic factors. In addition, patients with subcarinal LN metastasis had a significantly lower 5-year cumulative survival rate than those without (26.7% vs 60.9%; P<0.001). Conclusions: Subcarinal LN metastasis is a predictive factor for long-term survival in patients with ESCC.
引用
收藏
页码:3183 / 3186
页数:4
相关论文
共 19 条
[1]   Adenocarcinoma of the esophagus and cardia: A review of the disease and its treatment [J].
DeMeester, SR .
ANNALS OF SURGICAL ONCOLOGY, 2006, 13 (01) :12-30
[2]   Mortality after esophagectomy: Risk factor analysis [J].
Ferguson, MK ;
Martin, TR ;
Reeder, LB ;
Olak, J .
WORLD JOURNAL OF SURGERY, 1997, 21 (06) :599-604
[3]   Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008 [J].
Ferlay, Jacques ;
Shin, Hai-Rim ;
Bray, Freddie ;
Forman, David ;
Mathers, Colin ;
Parkin, Donald Maxwell .
INTERNATIONAL JOURNAL OF CANCER, 2010, 127 (12) :2893-2917
[4]  
Gotohda N, 2005, HEPATO-GASTROENTEROL, V52, P105
[5]  
Greene FL., 2002, AM JOINT COMMITTEE C
[6]   Effect of the number of lymph nodes sampled on postoperative survival of lymph node-negative esophageal cancer [J].
Greenstein, Alexander J. ;
Litle, Virginia R. ;
Swanson, Scott J. ;
Divino, Celia M. ;
Packer, Stuart ;
Wisnivesky, Juan P. .
CANCER, 2008, 112 (06) :1239-1246
[7]   Pre-tracheal lymph node metastasis in squamous cell carcinoma of the thoracic esophagus [J].
Hsu, CP ;
Hsu, NY ;
Shai, SE ;
Hsia, JY ;
Chen, CY .
EJSO, 2005, 31 (07) :749-754
[8]  
Japanese Research Society for Esophageal Diseases, 2008, JAP CLASS ES CANC
[9]   Lymph node metastases and prognosis in oesophageal carcinoma - A systematic review [J].
Kayani, B. ;
Zacharakis, E. ;
Ahmed, K. ;
Hanna, G. B. .
EJSO, 2011, 37 (09) :747-753
[10]   Impact of Lymph-Node Metastasis Site in Patients With Thoracic Esophageal Cancer [J].
Kunisaki, Chikara ;
Makino, Hirochika ;
Kimura, Jun ;
Oshima, Takashi ;
Fujii, Shoichi ;
Takagawa, Ryo ;
Kosaka, Takashi ;
Ono, Hidetaka A. ;
Akiyama, Hirotoshi .
JOURNAL OF SURGICAL ONCOLOGY, 2010, 101 (01) :36-42