Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Inohana, Chuo-ku, Chiba, Japan.
J Surg Oncol. 2012 Jun 15;105(8):756-60. doi: 10.1002/jso.23007. Epub 2011 Dec 12.
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.
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.
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 (χ(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.
Of the various factors, the number of pathologic metastatic LNs was the strongest indicator to predict the patients' survival.
新辅助放化疗（NACRT）后食管鳞癌（ESCC）患者病理性转移淋巴结（LNs）的数量与手术结果之间的相关性鲜有报道。我们评估了 NACRT 后 ESCC 中病理性转移淋巴结数量与手术结果之间的相关性。
对 88 例接受 NACRT 后手术的 ESCC 患者进行评估。评估 NACRT 的临床反应，并对原发肿瘤和切除的 LNs 的手术标本进行临床病理分析。
较少的病理性转移 LNs 与更好的生存相关。根据转移 LNs 的数量，当患者分为 2 个和 3 个转移 LNs 时，中位生存时间的差异最大（χ(2)：13.694，P < 0.001）。在临床因素方面，治疗前的初始 N 状态通过单因素分析对生存的影响最大（P = 0.064），而病理性转移 LNs 的数量是生存不良的危险因素，风险比为 5.128（95% C.I.：1.438-18.285，P = 0.012），通过多因素分析。
在各种因素中，病理性转移 LNs 的数量是预测患者生存的最强指标。
