The Number of Pathologic Lymph Nodes Involved is Still a Significant Prognostic Factor Even After Neoadjuvant Chemoradiotherapy in Esophageal Squamous Cell Carcinoma

被引:30
作者
Akutsu, Yasunori [1 ]
Shuto, Kiyohiko [1 ]
Kono, Tsuguaki [1 ]
Uesato, Masaya [1 ]
Hoshino, Isamu [1 ]
Shiratori, Toru [1 ]
Isozaki, Yuka [1 ]
Akanuma, Naoki [1 ]
Uno, Takashi [2 ]
Matsubara, Hisahiro [1 ]
机构
[1] Chiba Univ, Grad Sch Med, Dept Frontier Surg, Chuo Ku, Chiba 2608670, Japan
[2] Chiba Univ, Grad Sch Med, Dept Radiat Oncol, Chuo Ku, Chiba 2608670, Japan
关键词
esophageal cancer; squamous cell carcinoma; chemoradiotherapy; number of lymph nodes; neoadjuvant therapy; CHEMORADIATION THERAPY; RECURRENCE PATTERN; CANCER; SURVIVAL; METASTASES; MANAGEMENT; IMPACT;
D O I
10.1002/jso.23007
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
引用
收藏
页码:756 / 760
页数:5
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