Department of Surgery, Chutung Veterans Hospital, Hsinchu County, Taiwan.
J Surg Oncol. 2011 Apr;103(5):416-20. doi: 10.1002/jso.21850.
The total number of resected lymph nodes (TLN) has been shown to predict survival in esophageal cancer, but its relationship with recurrence has been rarely reported. We aim to study the prognostic factors in esophageal squamous cell carcinoma (ESCC) patients, with a particular focus on the role of TLN.
Two hundred sixty-eight ESCC patients who underwent transthoracic esophagectomy were selected for the study. A Cox regression model was used to identify prognostic factors.
Recurrence occurred in 115 of 268 patients. The median time to recurrence was 10 months (range, 1-58). The recurrence-free survival at 1, 3, and 5 years was 62.3%, 32.1%, and 28.5%, respectively. Multivariate analysis identified age (P = 0.001), N stage (N1-3 vs. N0, P = 0.001), tumor length (P = 0.019), and development of recurrence (P < 0.001) as independent prognostic factors for overall survival, whereas T (T3/4 vs. T1/2, P = 0.029) and N stage (N1-3 vs. N0, P = 0.017) were independent prognostic factors for recurrence. TLN was a significant factor only when predicting overall survival in N0 patients (HR, 0.976; 95% CI, 0.953-0.999; P = 0.042).
The TLN is not a prognostic factor for recurrence in ESCC patients undergone transthoracic esophagectomy.
切除的淋巴结总数（TLN）已被证明可预测食管癌的生存率，但很少有报道其与复发的关系。我们旨在研究食管鳞状细胞癌（ESCC）患者的预后因素，特别关注 TLN 的作用。
选择 268 例接受经胸食管切除术的 ESCC 患者进行研究。使用 Cox 回归模型确定预后因素。
268 例患者中有 115 例复发。复发的中位时间为 10 个月（范围，1-58）。1、3 和 5 年无复发生存率分别为 62.3%、32.1%和 28.5%。多变量分析确定年龄（P=0.001）、N 分期（N1-3 与 N0，P=0.001）、肿瘤长度（P=0.019）和复发的发生（P<0.001）是总生存的独立预后因素，而 T 分期（T3/4 与 T1/2，P=0.029）和 N 分期（N1-3 与 N0，P=0.017）是复发的独立预后因素。仅当预测 N0 患者的总生存时，TLN 才是一个显著因素（HR，0.976；95%CI，0.953-0.999；P=0.042）。
TLN 不是经胸食管切除术治疗的 ESCC 患者复发的预后因素。
